Basic Information
| Provider Information | |||||||||
| NPI: | 1871814459 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | ASHLEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | HQ MEDDACB | ||||||||
| Address2: | UNIT 28037 BLD 700 | ||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 09112 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | HQ MEDDACB | ||||||||
| Address2: | UNIT 28037 BLD 700 | ||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 09112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145902368 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2010 | ||||||||
| LastUpdateDate: | 03/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS015756 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.