Provider Demographics
NPI:1659646735
Name:ROBERTS, GREGORY JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOHN
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11541 E WINCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2040
Mailing Address - Country:US
Mailing Address - Phone:833-220-2685
Mailing Address - Fax:317-947-0839
Practice Address - Street 1:8240 NAAB RD STE 100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260
Practice Address - Country:US
Practice Address - Phone:317-338-7450
Practice Address - Fax:317-338-7464
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2018-08-03
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Provider Licenses
StateLicense IDTaxonomies
IN01076405A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery