Individual
GARY J ROBERTS
Active
Individual
GARY J ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301032254
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200022749
RR MEDICARE
MI
01
—
2002201181
BCBS MI
MI
05
—
2861626
—
MI
05
—
30128200
—
WI
Enumeration date
11/30/2005
Last updated
03/05/2019
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