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Individual

THOMAS HENRY ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
ST ANTHONY MEMORIAL HOSPITAL, 301 E HOMER ST, MICHIGAN CITY, IN 46360
(219) 861-8688
(219) 877-1081
Mailing address
113 E 4TH ST, MICHIGAN CITY, IN 46360-3301
(219) 873-3130
(219) 873-3132

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
01026864A
IN
207ZC0500X
Cytopathology Physician
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01026864A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01630255
BC/BC
IL
05
1003877130A
IN
01
6290876002
CIGNA
01
82439
BC/BS
IN
Enumeration date
08/25/2005
Last updated
04/16/2008
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