Individual
FELICIA D ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1055 N MAYFAIR RD, WAUWATOSA, WI 53226-3436
(414) 476-8450
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39596
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32575300
—
WI
01
—
P01021778
RR MEDICARE
WI
Enumeration date
08/24/2006
Last updated
08/05/2024
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