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General NPI Number Information
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NPI Number | 1467674093
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Entity Type | Organization
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Legal Business Name | GARY F ROBERTS PLLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3100 MACCORKLE AVE SE SUITE 610
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City | CHARLESTON
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State | WV
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Zip | 25304
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Country | US
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Telephone | 304-792-6275
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 MACCORKLE AVE SE SUITE 610
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City | CHARLESTON
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State | WV
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Zip | 25304
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Country | US
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Telephone | 304-792-6275
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GARY F ROBERTS
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Credential | DO
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Telephone | 304-792-6275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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