NPI 1043571904
Evan Roubal
Practice location
- Address
- 12054 Mississippi Dr N, Champlin, MN 55316-2110
- Phone
- (760) 725-5298
- Mailing address
- 12054 Mississippi Drive, Champlin, MN 55316
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1043571904
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 6 Jun 2012
- Record last updated
- 6 Jun 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.