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NPI Code Detail

MEDICARE: TSAMARA ROBERTS DO

MEDICARE: TSAMARA ROBERTS DO
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
1390200000XStudent in an Organized Health Care Education/Training ProgramOT025646PA

General Provider Information

NPI Number : 1720913767
Entity Type Code : Individual
Provider Name (Legal Business Name) : TSAMARA ROBERTS DO
Provider Business Mailing Address
First Line : 5234 FAIRLAWN ST
Second Line :
City : ERIE
State : PA
Zip : 16509-2408
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5515 PEACH ST
Second Line :
City : ERIE
State : PA
Zip : 16509-2603
Country : US
Telephone Number : 814-868-8217
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

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Directions to “ TSAMARA ROBERTS DO” Practice Location

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