Individual
MR. VAN GREGORY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8202 S ACCESS RD BLDG 946, COLUMBUS, OH 43217-5903
(614) 989-1213
(614) 336-6635
Mailing address
6158 NORTHCLIFF BLVD, DUBLIN, OH 43016-6713
(301) 602-7463
(614) 336-6635
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002763
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002763
OHIO LICENSE
OH
Enumeration date
10/27/2005
Last updated
12/15/2021
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