Individual
CARSON ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
306 E MAUMEE ST STE 201, ANGOLA, IN 46703-2035
(260) 667-2700
(260) 667-2611
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11021038A
IN
208D00000X
General Practice Physician
02006478A
IN
Other
Enumeration date
06/08/2020
Last updated
08/30/2023
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