Organization
ROEBUCKDERM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER ROEBUCK NP (PRESIDENT)
(248) 932-2607
Entity
Organization
Contact information
Practice address
5807 W MAPLE RD STE 171, WEST BLOOMFIELD, MI 48322-4483
(248) 932-2607
Mailing address
5807 W MAPLE RD STE 171, WEST BLOOMFIELD, MI 48322-4483
(248) 932-2607
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4301065408
MI
Other
Enumeration date
12/29/2014
Last updated
12/29/2014
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