Individual
ANDREW W MCROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 HOSPITAL WAY, BUILDING A SUITE 201, POCATELLO, ID 83201-5175
(208) 239-2620
(208) 239-3778
Mailing address
500 S 11TH AVE, POCATELLO, ID 83201-4881
(208) 232-7434
(208) 233-6446
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M6814
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002768500
—
ID
Enumeration date
09/07/2005
Last updated
03/19/2014
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