Individual
DR. ROBERT C. JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
1500 W BIG BEAVER RD STE 110, TROY, MI 48084-3522
(248) 508-4641
Mailing address
598 BARRINGTON PARK, BLOOMFIELD HILLS, MI 48304-2122
(248) 508-4641
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
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
09/01/2023
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