Robertson, James Wallace
Robertson, James Wallace is an individual health care provider with primary practice located at 5024 N Royal Dr , Traverse City MI 49684-9230. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Robertson, James Wallace can be contacted via phone (231) 935-0555.Contact Information
Primary practice address
5024 N Royal Dr
Traverse City MI 49684-9230
Phone: (231) 935-0555
Fax: (231) 935-0562
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 4301065685 | Michigan |
Profile Details
| NPI number | 1457357832 |
|---|---|
| LBN Legal business name | Robertson, James Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Dec 24th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457357832 | NPPES |
| Michigan | MEDICAID | 1065685 |
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