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Individual

ROBERT KNOWLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 ELM AVE SE, ROANOKE, VA 24013-2222
(540) 224-4325
(540) 224-4399
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
(540) 224-5684

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
0101058403
VA
208600000X
Surgery Physician
Primary
0101058403
VA
208600000X
Surgery Physician
15835
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002960301
MEDICARE PTAN
NH
05
3077483
NH
Enumeration date
07/08/2005
Last updated
08/23/2022
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