MEDICARE: MRS. SHEILA LYNN 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	2084P0800X	Psychiatry Physician	20567	KY

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	:	1588667505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEILA LYNN ROBERTS MD

Provider Business Mailing Address
First Line	:	6400 DUTCHMANS PKWY
Second Line	:	STE 331
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3344
Country	:	US
Telephone Number	:	502-896-0835
Fax Number	:	502-896-0836

Provider Business Practice Location Address
First Line	:	6400 DUTCHMANS PKWY
Second Line	:	STE 331
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3344
Country	:	US
Telephone Number	:	502-896-0835
Fax Number	:	502-896-0836

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/07/2008

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