Provider Demographics
NPI:1720422926
Name:ROBERTS, MAUREEN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ELIZABETH
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 1:300 BRETZ CT STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17074-8615
Mailing Address - Country:US
Mailing Address - Phone:717-221-5940
Mailing Address - Fax:717-233-1939
Practice Address - Street 1:300 BRETZ CT STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:PA
Practice Address - Zip Code:17074-8615
Practice Address - Country:US
Practice Address - Phone:717-221-5940
Practice Address - Fax:717-233-1939
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3316207V00000X
PAMD471385207VX0201X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology