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NPI Code Detail

MEDICARE: MARKUS EDUARDO ROBERSON CRNA

MEDICARE:   MARKUS EDUARDO ROBERSON  CRNA
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
1367500000XCertified Registered Nurse Anesthetist140400GA

General Provider Information

NPI Number : 1356396600
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARKUS EDUARDO ROBERSON CRNA
Provider Business Mailing Address
First Line : 6816 BAYPOINTE DR
Second Line :
City : MACON
State : GA
Zip : 31220
Country : US
Telephone Number : 478-955-4968
Fax Number :
Provider Business Practice Location Address
First Line : 6816 BAY POINT DR
Second Line :
City : MACON
State : GA
Zip : 31220-5260
Country : US
Telephone Number : 478-955-4968
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 07/08/2007

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Directions to “ MARKUS EDUARDO ROBERSON CRNA” Practice Location

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