Provider Demographics
NPI:1699771360
Name:ROBERTS, ANNE-MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE-MARIE
Middle Name:
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 1:6480 W RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1919
Mailing Address - Country:US
Mailing Address - Phone:702-845-2841
Mailing Address - Fax:702-252-4405
Practice Address - Street 1:2500 PERLITER AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7309
Practice Address - Country:US
Practice Address - Phone:702-396-4165
Practice Address - Fax:702-656-0026
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88960207RI0200X
NV12880207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268391100Medicaid
FL268391100Medicaid
FLI00612Medicare UPIN
NVAX283ZMedicare PIN