Individual
ROBERTO S CONCEPCION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 DELAWARE AVENUE, MARION, OH 43301-1814
(740) 383-7950
(740) 375-8164
Mailing address
L-3549, COLUMBUS, OH 43260-0001
(740) 383-7927
(740) 383-7942
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35.049715
OH
208800000X
Urology Physician
35049715C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0567686
—
OH
01
—
0647181
PALMETTO MEDICARE
—
01
—
1900051
UHC
—
01
—
311098079
TAX ID #
—
01
—
311098079007
CIGNA
—
01
—
340006973
TRAVELERS MEDICARE
—
01
—
353077
SUBMITTER NO.
—
01
—
643269
AETNA
—
Enumeration date
06/09/2006
Last updated
10/07/2014
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