Individual
RONALD ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
E-0415
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16428000000
QUALCHOICE
AR
01
—
5J636
BLUE CROSS BLUE SHIELD
AR
01
—
5J6367666
ADDITIONAL MEDICARE
AR
01
—
E0415
TRICARE
AR
Enumeration date
10/13/2006
Last updated
01/07/2008
Update your record
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