Provider Demographics
NPI:1235530759
Name:ROBERTS, DANIEL (MB BS, FRCA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MB BS, FRCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S EUTAW ST
Mailing Address - Street 2:APT 1002
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1628
Mailing Address - Country:US
Mailing Address - Phone:443-240-4085
Mailing Address - Fax:
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:SHOCK TRAUMA CENTRE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:443-240-4085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program