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Individual
MARK ANDREW ROBERTS
Active
Individual
MARK ANDREW ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-00509
NC
363AM0700X
Medical Physician Assistant
0010-00509
NC
363AM0700X
Medical Physician Assistant
C0002314
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00386964
RR MEDICARE
NC
Enumeration date
09/23/2005
Last updated
06/05/2025
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