Individual
DR. MARK A ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 EDWINA STREET, EVERGREEN, AL 36401
(251) 578-4300
(251) 578-4307
Mailing address
106 EDWINA STREET, EVERGREEN, AL 36401
(251) 578-4300
(251) 578-4307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15010
AL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
15010
AL
208VP0000X
Pain Medicine Physician
PM.282
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051558849
—
AL
Enumeration date
07/07/2006
Last updated
06/13/2022
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