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General NPI Number Information
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NPI Number | 1053364968
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Entity Type | Individual
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Provider Name | ROBENA ELAINE MEDBERY M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 2085 HENRY TECKLENBURG DR STE 106
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City | CHARLESTON
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State | SC
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Zip | 29414-7711
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Country | US
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Telephone | 843-958-2440
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Fax | 843-958-2599
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Provider Business Mailing Address
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Address Line | PO BOX 751649
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City | CHARLOTTE
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State | NC
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Zip | 28275-1649
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Country | US
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Telephone | 888-472-0043
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Fax | 843-724-2440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 50976
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MD057979L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 25895
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License Number State | SC
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