Individual
DR. DOUGLAS E ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7182 WOODROW ST STE 200, IRMO, SC 29063-2958
(803) 749-1111
(803) 749-0050
Mailing address
7182 WOODROW ST STE 200, IRMO, SC 29063-2832
(803) 749-1111
(803) 749-0050
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
13895
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13895
SC MEDICAL LICENSE
SC
05
—
138951
—
SC
Enumeration date
06/22/2006
Last updated
02/26/2024
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