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NPI Code Detail

MEDICARE: TODD ALAN ROBERTS MD

MEDICARE: TODD ALAN 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
1207P00000XEmergency Medicine PhysicianMA64654NJ
2207PE0004XEmergency Medical Services (Emergency Medicine) Physician24600NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649208844
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD ALAN ROBERTS MD
Provider Business Mailing Address
First Line : 366 196TH
Second Line :
City : PLEASANT DALE
State : NE
Zip : 68423-9118
Country : US
Telephone Number : 402-826-5937
Fax Number :
Provider Business Practice Location Address
First Line : 2300 S 16TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68502-3704
Country : US
Telephone Number : 402-481-8644
Fax Number : 402-481-3061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 05/29/2009

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