Basic Information
| Provider Information | |||||||||
| NPI: | 1366815581 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERTS ORTHOPEDIC SERVICES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27207 LAHSER RD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480342168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485958518 | ||||||||
| FaxNumber: | 2485958619 | ||||||||
| Practice Location | |||||||||
| Address1: | 27207 LAHSER RD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480342168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485958518 | ||||||||
| FaxNumber: | 2485958619 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2015 | ||||||||
| LastUpdateDate: | 11/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | ROBERTS | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2485958518 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 5101011614 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.