Individual
DR. KEVIN WALLACE ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1375 S LAPEER RD, SUITE 106, LAKE ORION, MI 48360-1421
(248) 693-9040
(248) 693-9007
Mailing address
1375 S LAPEER RD, SUITE 106, LAKE ORION, MI 48360-1421
(248) 693-9040
(248) 693-9007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101009588
MI
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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