Provider Demographics
NPI:1649774449
Name:ROBERTS, DARIAN LEIGH (MD)
Entity type:Individual
Prefix:
First Name:DARIAN
Middle Name:LEIGH
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:OH
Mailing Address - Zip Code:44672-1643
Mailing Address - Country:US
Mailing Address - Phone:330-537-4661
Mailing Address - Fax:330-537-4482
Practice Address - Street 1:605 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:OH
Practice Address - Zip Code:44672-1643
Practice Address - Country:US
Practice Address - Phone:330-537-4661
Practice Address - Fax:330-537-4482
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0452288Medicaid