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NPI Code Detail

MEDICARE: ANDREW W MCROBERTS M.D.

MEDICARE:   ANDREW W MCROBERTS  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
1208600000XSurgery PhysicianM6814ID

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 : 1992799894
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW W MCROBERTS M.D.
Provider Business Mailing Address
First Line : 500 S 11TH AVE
Second Line :
City : POCATELLO
State : ID
Zip : 83201-4881
Country : US
Telephone Number : 208-232-7434
Fax Number : 208-233-6446
Provider Business Practice Location Address
First Line : 777 HOSPITAL WAY
Second Line : BUILDING A SUITE 201
City : POCATELLO
State : ID
Zip : 83201-5175
Country : US
Telephone Number : 208-239-2620
Fax Number : 208-239-3778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 03/19/2014

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Directions to “ ANDREW W MCROBERTS M.D.” Practice Location

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