Individual
JOHN W ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD00038625
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039590
LABOR & INDUSTRY
WA
01
—
3636RO
BLUE SHIELD
WA
05
—
8256620
—
WA
01
—
MD8984W
ALASKA MEDICAID
WA
01
—
US2367299
AETNA/USHC SPECIALIST
WA
Enumeration date
08/15/2006
Last updated
04/07/2008
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