Individual
JOHN M ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 WEST HIGHWAY 22, SANTO DOMINGO, NM 87052-0340
(505) 465-3060
Mailing address
PO BOX 340, KEWA PUEBLO HEALTH CORPORATION, SANTO DOMINGO, NM 87052-0340
(505) 465-3060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
94-375
NM
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
94-375
NM
Other
Enumeration date
07/31/2008
Last updated
08/07/2015
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