Individual
ROBENA ELAINE MEDBERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2085 HENRY TECKLENBURG DR STE 106, CHARLESTON, SC 29414-7711
(843) 958-2440
(843) 958-2599
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
25895
SC
2085R0001X
Radiation Oncology Physician
50976
GA
2085R0001X
Radiation Oncology Physician
MD057979L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001381
BLUE CROSS/BLUE SHIELD
GA
01
—
002183
BLUE CROSS/BLUESHIELD
GA
05
—
00941839A
—
GA
05
—
00941839B
—
GA
05
—
00941839C
—
GA
05
—
00941839E
—
GA
05
—
114381600
—
MD
05
—
258955
—
SC
01
—
911235
BLUE CROSS/ BLUE SHIELD
GA
Enumeration date
05/19/2006
Last updated
06/03/2024
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