Individual
JOHN A ROEBUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, 1H247 UNIVERSITY HOSPITAL, ANN ARBOR, MI 48109-5048
(734) 936-4280
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704196447
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4280790
—
MI
01
—
430F364420
BCBSM
MI
Enumeration date
03/02/2006
Last updated
02/04/2015
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