Individual
MR. CARROLL BRACEY ROBERTSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
902B ROANOKE AVE, ELIZABETH CITY, NC 27909-5565
(252) 384-0154
(252) 335-2731
Mailing address
902B ROANOKE AVE, ELIZABETH CITY, NC 27909-5565
(252) 384-0154
(252) 335-2731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9300298
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8972152
—
NC
Enumeration date
07/12/2006
Last updated
03/06/2009
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