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Individual
DR. DOUGLAS E. ROBERTS JR.
Active
Individual
DR. DOUGLAS E. ROBERTS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G35606
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G356060
BLUE SHIELD
—
05
—
00G356060
—
CA
01
—
0616650001
DME
—
01
—
110039741
RAILROAD MEDICARE
—
01
—
93555B036
WPS TRICARE
—
01
—
CA0103
JOHN DEERE
—
Enumeration date
05/31/2005
Last updated
03/07/2023
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