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Individual

DR. JOHN V. ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Mailing address
PO BOX 63362, CHARLOTTE, NC 28263-3362
(919) 684-8111

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2014-00737
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011846
MEDICARE GROUP PAYEE NUMBER
AL
01
1063439065
SITE GROUP PAYEE NUMBER
AL
05
631300001
AL
01
T-2105
TEMPORARY STATE MEDICAL LICENSE
MS
Enumeration date
07/06/2008
Last updated
10/03/2023
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