Individual
MRS. LASEAN BOST ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-7080
(336) 718-9622
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-7080
(336) 718-9622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200601049
NC
208M00000X
Hospitalist Physician
Primary
2006-01049
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2335816
MEDICARE PTAN, C.HOSP.GRP.WILKES
NC
01
—
NC2594B
MEDICARE PTAN, INDIVIDUAL
NC
Enumeration date
08/01/2006
Last updated
10/25/2020
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