MEDICARE: PAMELA R ROBERTS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	35479	NC
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	24788	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	242627803	OTHER	OK	MEDICARE OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134104268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA R ROBERTS MD

Provider Business Mailing Address
First Line	:	PO BOX 53188
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73152-3188
Country	:	US
Telephone Number	:	405-271-4351
Fax Number	:	405-271-1216

Provider Business Practice Location Address
First Line	:	750 NE 13TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5010
Country	:	US
Telephone Number	:	405-271-4351
Fax Number	:	405-271-1216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	01/20/2012

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Directions to “ PAMELA R ROBERTS MD” Practice Location

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