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NPI Code Detail

MEDICARE: MR. MICHAEL K ROBERTS MD

MEDICARE: MR. MICHAEL K 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
1207Q00000XFamily Medicine Physician35080885OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578550620
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL K ROBERTS MD
Provider Business Mailing Address
First Line : 1460 TOD AVE NW
Second Line :
City : WARREN
State : OH
Zip : 44485-2407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1460 TOD AVE NW
Second Line :
City : WARREN
State : OH
Zip : 44485-2407
Country : US
Telephone Number : 330-392-0311
Fax Number : 216-229-2897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 09/11/2023

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