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General NPI Number Information
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NPI Number | 1245628007
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Entity Type | Organization
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Legal Business Name | ROBESON FAMILY HEALTHCARE, PC
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Dates
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Enumeration Date | 01/02/2015
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 220 WINTERGREEN DR SUITE A
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City | LUMBERTON
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State | NC
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Zip | 28358-2376
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Country | US
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Telephone | 910-536-1896
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Fax | 910-536-1935
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Provider Business Mailing Address
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Address Line | 220 WINTERGREEN DR SUITE A
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City | LUMBERTON
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State | NC
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Zip | 28358-2376
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Country | US
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Telephone | 910-536-1896
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Fax | 910-536-1935
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TABATHA L OBEDA
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Credential | FNP
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Telephone | 910-536-1896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F0311109
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License Number State | NC
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