Individual
COLIN MATTHEW ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-5856
Mailing address
4307 SE HARRISON ST, PORTLAND, OR 97215-3156
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MD23293
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262354
—
OR
Enumeration date
08/03/2006
Last updated
11/18/2011
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