Individual
ERIC G ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 W OKLAHOMA AVE, 4TH FLOOR GALLERIA, MILWAUKEE, WI 53215
(414) 646-5410
Mailing address
2900 W OKLAHOMA AVE, 4TH FL, MILWAUKEE, WI 53215-4330
(414) 646-2438
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125053403
IL
207RC0000X
Cardiovascular Disease Physician
Primary
55936
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036125276
—
IL
05
—
100031179
—
WI
01
—
206147
MEDICARE PTAN (GROUP)
—
01
—
206147021
MEDICARE PTAN (INDIVIDUAL)
—
01
—
CE9230
RAILROAD MEDICARE PTAN (GROUP)
—
01
—
P00880127
RAILROAD MEDICARE PTAN (INDIVIDUAL)
—
Enumeration date
07/15/2008
Last updated
12/03/2021
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