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Individual

DUDLEY ROBERTS III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
18245 E 10 MILE RD, ROSEVILLE, MI 48066-5807
(586) 774-8710
Mailing address
18245 E 10 MILE RD, SUITE 120, ROSEVILLE, MI 48066-5807
(586) 774-8710

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DR051585
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104715716
MI
01
110227501
RRMR
MI
01
1105015902
BS
MI
01
383712316
PPOM
MI
01
P115806
BCN
MI
Enumeration date
09/20/2005
Last updated
11/01/2013
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