| Kay Robertson | |
|
44200 Woodward Ave Suite 205 Pontiac MI 48341-5045 | |
| (248) 858-9400 | |
| (248) 858-9493 |
| Full Name | Kay Robertson |
|---|---|
| Speciality | Internal Medicine |
| Location | 44200 Woodward Ave, Pontiac, Michigan |
| Authorized Official Name and Position | Kay A Robertson (OWNER) |
| Authorized Official Contact | 2488589400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kay Robertson 44200 Woodward Ave Suite 205 Pontiac MI 48341-5045 Ph: (248) 858-9400 | Kay Robertson 44200 Woodward Ave Suite 205 Pontiac MI 48341-5045 Ph: (248) 858-9400 |
| NPI Number | 1154460830 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 03/04/2011 |
| Medicare PECOS PAC ID | 6800822149 |
|---|---|
| Medicare Enrollment ID | O20050708000812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154460830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301068781 (Michigan) | Primary |
| 208000000X | Pediatrics | 4301068781 (* (Not Available)) | Secondary |
| Provider Name | Kay Robertson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649262080 PECOS PAC ID: 0446245484 Enrollment ID: I20040419000487 |
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