MEDICARE: SANDY J ROBERTSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101235778	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CJ2302	OTHER		MEDICARE RAILROAD

General Provider Information

NPI Number	:	1255339123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDY J ROBERTSON MD

Provider Business Mailing Address
First Line	:	PO BOX 749112
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-9112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2871 ROCKFISH VALLEY HWY
Second Line	:
City	:	NELLYSFORD
State	:	VA
Zip	:	22958
Country	:	US
Telephone Number	:	434-297-6000
Fax Number	:	434-297-6550

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	10/08/2025

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