MEDICARE: DR. ELIZABETH B ROBERTS M.D.

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	207V00000X	Obstetrics & Gynecology Physician	0101238122	VA

Other Identifiers

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

General Provider Information

NPI Number	:	1588656979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH B ROBERTS M.D.

Provider Business Mailing Address
First Line	:	7130 GLEN FOREST DR
Second Line	:	SUITE 101
City	:	RICHMOND
State	:	VA
Zip	:	23226-3754
Country	:	US
Telephone Number	:	804-662-6060
Fax Number	:	804-282-8678

Provider Business Practice Location Address
First Line	:	7611 FOREST AVE
Second Line	:	SUITE 200
City	:	RICHMOND
State	:	VA
Zip	:	23229-4946
Country	:	US
Telephone Number	:	804-288-4084
Fax Number	:	804-288-3567

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	06/10/2011

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