Individual
DR. MARK IAN ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 BURRO ALY, MORENCI, AZ 85540-9647
(928) 865-7501
(928) 865-9186
Mailing address
3474 N PROSPECTORS RD, APACHE JUNCTION, AZ 85119-9872
(302) 538-0929
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C10006136
DE
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
45322
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001111501
—
DE
05
—
001111501
—
DE
Enumeration date
01/10/2006
Last updated
03/07/2024
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