Basic Information
| Provider Information | |||||||||
| NPI: | 1205810959 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WESTIN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | KENNETH | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 320 E MAIN ST | ||||||||
| Address2: | CUYUNA REGIONAL MEDICAL CENTER | ||||||||
| City: | CROSBY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 56441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2185467000 | ||||||||
| FaxNumber: | 2185454456 | ||||||||
| Practice Location | |||||||||
| Address1: | 320 E MAIN ST | ||||||||
| Address2: | CUYUNA REGIONAL MEDICAL CENTER | ||||||||
| City: | CROSBY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 564411645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2185467000 | ||||||||
| FaxNumber: | 2185454456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2005 | ||||||||
| LastUpdateDate: | 11/19/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 36760 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 6D052WE | 01 | BCBS | OTHER | 5306751 | 01 | AETNA | OTHER | 236071 | 01 | AMERICAS PPO | OTHER | E020 | 01 | TRICARE | OTHER | 0101295 | 01 | MEDICA | OTHER | 112554C750 | 01 | UCARE | OTHER | 912224900 | 05 | MN | MEDICAID | HP26705 | 01 | HEALTHPARTNERS | OTHER | 080065681 | 01 | RR MEDICARE | OTHER | 089005716 | 01 | MEDICARE | OTHER | NS1141008754 | 01 | PREFERRED ONE | OTHER |