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Individual

DR. ROBERT C. JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.D.

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901017024
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2901017024
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104472224
MI
05
124472206
MI
01
147805
GREAT LAKES HEALTH PLAN
MI
01
7164521
AETNA
01
9755066630
BLUE CROSS BLUE SHIELD
MI
01
RJ017024
CHAMPUS-CHAMPUS
01
U93813
HAP
MI
Enumeration date
07/29/2005
Last updated
08/21/2026
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