Provider Demographics
NPI:1811072507
Name:NIEBERT, ROBERT GEORGE (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GEORGE
Last Name:NIEBERT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 E TUDOR RD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1039
Mailing Address - Country:US
Mailing Address - Phone:907-222-0668
Mailing Address - Fax:907-334-1030
Practice Address - Street 1:2217 E TUDOR RD
Practice Address - Street 2:SUITE 18
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1039
Practice Address - Country:US
Practice Address - Phone:907-222-0668
Practice Address - Fax:907-334-1030
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL503OtherPHARMACIST LICENSE NUMBER