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Individual

MARK A ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
10552 N WATTS SPRINGS PARK RD, EDGERTON, WI 53534-8947
(312) 961-9391
Mailing address
PO BOX 111, EDGERTON, WI 53534-0111
(312) 961-9391

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
16402
OK
2083X0100X
Occupational Medicine Physician
Primary
31165
WI

Other

Enumeration date
04/24/2018
Last updated
04/24/2018
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