Healthcare Provider Details

I. General information

NPI: 1538150750
Provider Name (Legal Business Name): DAVID JOSEPH ROBERTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HIGHLAND AVE
SALEM MA
01970-2714
US

IV. Provider business mailing address

81 HIGHLAND AVE
SALEM MA
01970-2714
US

V. Phone/Fax

Practice location:
  • Phone: 978-744-5900
  • Fax: 978-745-9534
Mailing address:
  • Phone: 978-744-5900
  • Fax: 978-745-9534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number54616
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number54616
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: