Individual
DAVID ANTHONY RODEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
517 MOYE BLVD, GREENVILLE, NC 27834-2849
(252) 744-2832
(252) 744-3457
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
2010-00640
NC
2086S0120X
Pediatric Surgery Physician
MD429509
PA
2086S0120X
Pediatric Surgery Physician
TP683
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158YP
BCBSNC
NC
05
—
5914874
—
NC
Enumeration date
09/01/2006
Last updated
04/05/2022
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