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General NPI Number Information
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NPI Number | 1548269962
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Entity Type | Individual
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Provider Name | EDWARD CONRAD ROBLES MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 10305 HAMPTONS PARK DR STE 101
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7217
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Country | US
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Telephone | 704-316-5388
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Fax | 704-316-1848
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone | 704-316-5388
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Fax | 704-316-1848
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301066617
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 4301066617
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2015-00266
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License Number State | NC
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