Provider Demographics
NPI:1336135052
Name:ROBERTS, MICHAEL WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 DOCTOR HENRY NORRIS DR
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-3176
Mailing Address - Country:US
Mailing Address - Phone:828-287-9260
Mailing Address - Fax:828-287-9709
Practice Address - Street 1:139 DOCTOR HENRY NORRIS DR
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-3176
Practice Address - Country:US
Practice Address - Phone:828-287-9260
Practice Address - Fax:828-287-9709
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-00702207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC72393OtherBCBS
NC1162410001OtherDME
NC67078OtherMECOST
NC8972393Medicaid
NC8972393Medicaid
2224741BMedicare PIN