Individual
DR. SUSAN K. ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1842 SUGARLAND DR, SUITE 101, SHERIDAN, WY 82801-5719
(307) 673-4960
(307) 673-4951
Mailing address
1842 SUGARLAND DR, SUITE 101, SHERIDAN, WY 82801-5719
(307) 673-4960
(307) 673-4951
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6397A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W24224
MEDICARE PTAN
WY
Enumeration date
06/16/2005
Last updated
12/01/2011
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