Individual
JOHN ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3577 W 13 MILE RD, ROYAL OAK, MI 48073-6710
(248) 551-5490
(248) 551-0089
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4301405966
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
320F362430
BCBSM
MI
05
—
3229649
—
MI
Enumeration date
03/29/2006
Last updated
10/23/2020
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