Individual
PROF. RICHARD GUY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21 S VINE ST, BELLEVILLE, WI 53508-9179
(608) 424-3384
(608) 424-6353
Mailing address
777 S MILLS ST, MADISON, WI 53715-1849
(608) 263-3598
(608) 263-5813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25691
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25691
LICENSE
WI
05
—
30531300
—
WI
Enumeration date
09/30/2005
Last updated
11/27/2012
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