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Individual

DR. KENNETH BARRY ROBERTS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-8060
Mailing address
PO BOX 13605, GREENSBORO, NC 27415-3605
(336) 547-1877

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9701565
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1117Q
BCBS NC
NC
01
5782601
AETNA
NC
01
78112
MEDCOST
NC
05
891117Q
NC
Enumeration date
06/15/2006
Last updated
07/09/2007
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