Individual
ROY W ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11108 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1730
(260) 266-5700
(260) 266-9520
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01037760A
IN
207RC0000X
Cardiovascular Disease Physician
01037760A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01037760A
IN
208600000X
Surgery Physician
01037760A
IN
2086S0129X
Vascular Surgery Physician
01037760A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641097
ANTHEM
IN
01
—
060070573
RR MEDICARE
IN
05
—
0977117
—
OH
05
—
100465520
—
IN
01
—
P00782372
R.R. MEDICARE
IN
Enumeration date
08/16/2005
Last updated
06/03/2025
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