Individual
MRS. DEANNA MARIE ROBERTS
Active
Individual
MRS. DEANNA MARIE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
1230
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
NOT A BILLING PROVIDER
—
Enumeration date
06/16/2022
Last updated
06/16/2022
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