Individual
KAY ALEXA ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
44200 WOODWARD AVE, SUITE 205, PONTIAC, MI 48341-5045
(248) 858-9400
(248) 858-9493
Mailing address
44200 WOODWARD AVE, SUITE 205, PONTIAC, MI 48341-5045
(248) 858-9400
(248) 858-9493
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301068781
MI
208000000X
Pediatrics Physician
4301068781
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05165444
EDFMG
—
01
—
5315008648
CONTROLLED SUBSTANCE
MI
Enumeration date
08/22/2005
Last updated
03/07/2023
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