Individual
DR. STEPHANIE FELICIA ROBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-4440
Mailing address
PO BOX 1746, INDIANAPOLIS, IN 46206-1746
(877) 383-4442
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
053599
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
436845418
—
GA
01
—
P00683397
RR MEDICARE
GA
Enumeration date
07/20/2006
Last updated
04/06/2022
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