Individual
GABRIEL ISAAC ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1097A COOK RD, ORANGEBURG, SC 29118-8209
(803) 395-3370
Mailing address
1097A COOK RD, ORANGEBURG, SC 29118-8209
(803) 395-3370
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MPA.4368
SC
Other
Enumeration date
04/09/2022
Last updated
04/24/2024
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