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Individual
MR. MARK A ROBERTS
Active
Individual
MR. MARK A ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
020863
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020863
MED BD LLR
SC
05
—
T38368
—
SC
Enumeration date
10/27/2006
Last updated
01/30/2018
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