Nathan Bryan Roberts, DC
Individual provider Active NPI Chiropractor · Bangor, MI
NPI 1598079873 · NPPES record last updated Feb 14, 2017
Key facts
- NPI
- 1598079873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- NR009713 (MI)
- Practice address
- 125 W Monroe St
Bangor, MI 49013-1332 - Phone
- (269) 427-2800
- Fax
- (269) 621-2556
- NPI assigned
- Jul 29, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NR009713 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BH Chiropractic Clinics, PLLC | Chiropractor | Current | Accepting new patients |
| Ahad E Lotfi DC PLLC | Chiropractor | Past | Accepting new patients |
Locations
125 W Monroe St
Bangor, MI 49013
Phone (269) 427-2800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | NR009713 | MI | Yes |
Addresses
Primary practice location
125 W Monroe St
Bangor, MI 49013-1332
Mailing address
PO Box 124
Bangor, MI 49013-0124
Phone (734) 845-9064
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598079873 | Medicaid | MI |
Other providers in Bangor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.