Individual
MELVILLE PARKER ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 ANDOVER RD, PORTLAND, ME 04102-1954
(207) 761-6642
(207) 773-2603
Mailing address
10 ANDOVER RD, PORTLAND, ME 04102-1954
(207) 761-6642
(207) 773-2603
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
015187
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043376482
FEDERAL TAX ID
ME
05
—
154600000
—
ME
05
—
287310099
—
ME
Enumeration date
11/02/2006
Last updated
05/23/2008
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