Individual
GERALD ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES, 2111 COLLEGE DRIVE, GALLUP, NM 87301
(505) 863-1820
Mailing address
REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES, 1901 RED ROCK DRIVE, GALLUP, NM 87301
(505) 863-7000
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
72-73
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09431
—
NM
01
—
10002106
LOVELACE HEALTH/SALUD
NM
05
—
228727
—
AZ
01
—
85031326887301A017
CHAMPUS
—
01
—
NM002282
BCBS
NM
01
—
PROVP15197
MOLINA
NM
Enumeration date
02/02/2006
Last updated
07/09/2007
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