Individual
DR. JAMES WALLACE ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5024 N ROYAL DR, TRAVERSE CITY, MI 49684-9230
(231) 935-0555
(231) 935-0562
Mailing address
5024 N ROYAL DR, TRAVERSE CITY, MI 49684-9230
(231) 935-0555
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301065685
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1065685
—
MI
Enumeration date
06/22/2005
Last updated
12/24/2020
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