Provider Demographics
NPI:1033132279
Name:ROBERTS, STEVEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8001 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3038
Mailing Address - Country:US
Mailing Address - Phone:215-676-8300
Mailing Address - Fax:215-698-7707
Practice Address - Street 1:8001 ROOSEVELT BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3038
Practice Address - Country:US
Practice Address - Phone:215-676-8300
Practice Address - Fax:215-698-7707
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-045546-E207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7928807Medicaid
PA001750435Medicaid
PA001750435Medicaid