Organization
DUDLEY ROBERTS M.D, L.L.C.
Active
Other names
Dudley Roberts III, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DUDLEY ROBERTS III M.D. (OWNER)
(586) 774-8710
Entity
Organization
Contact information
Practice address
18245 E 10 MILE RD, SUITE 120, ROSEVILLE, MI 48066-5807
(586) 774-8710
(586) 774-8809
Mailing address
18245 E 10 MILE RD, SUITE 120, ROSEVILLE, MI 48066-5807
(586) 774-8710
(586) 774-8809
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DR051585
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1105015902
BCBS
MI
05
—
4715716
—
MI
01
—
DR015585
LICENSE
MI
01
—
P00240306
RAILROAD MEDICARE
MI
Enumeration date
06/22/2006
Last updated
04/29/2020
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