Provider Demographics
NPI:1154489722
Name:ROBERTS, ANN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1414 N VERCLER RD
Mailing Address - Street 2:BUILDING 1
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1092
Mailing Address - Country:US
Mailing Address - Phone:509-928-6383
Mailing Address - Fax:509-926-9420
Practice Address - Street 1:1414 N VERCLER
Practice Address - Street 2:BUILDING 1
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1092
Practice Address - Country:US
Practice Address - Phone:509-928-6383
Practice Address - Fax:509-926-9420
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2011-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00043821208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1003787Medicaid