Individual
MARK S ROBERTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3250 MIDDLE URBANA RD, SPRINGFIELD, OH 45502-9285
(937) 399-7777
(937) 399-6794
Mailing address
3250 MIDDLE URBANA RD, SPRINGFIELD, OH 45502-9285
(937) 399-7777
(937) 399-6794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-04-6604-R
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000014201
ANTHEM
OH
01
—
0101219
UNITED HEALTH CARE
OH
05
—
0466419
—
OH
01
—
080010552
RR MEDICARE
OH
01
—
311202780008
CIGNA
OH
01
—
4013944
AETNA
OH
01
—
OH0032545
TRICARE/CHAMPUS
OH
Enumeration date
05/24/2005
Last updated
12/17/2020
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