MEDICARE: DR. DAVID EDWARD 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	207R00000X	Internal Medicine Physician	MD417828	PA

General Provider Information

NPI Number	:	1235179805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID EDWARD ROBERTS MD

Provider Business Mailing Address
First Line	:	203 KAREN DR
Second Line	:
City	:	SCRANTON
State	:	PA
Zip	:	18505-2207
Country	:	US
Telephone Number	:	570-991-2099
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 71ST ST
Second Line	:	SUITE 620
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-3038
Country	:	US
Telephone Number	:	800-610-0886
Fax Number	:

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/06/2007

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