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Individual

CHARLES RICHARD ROBERTS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1805 27TH ST, PORTSMOUTH, OH 45662-2640
(740) 356-8231
(740) 356-3686
Mailing address
1735 27TH ST STE B06, PORTSMOUTH, OH 45662-2681
(740) 356-8681
(740) 353-7900

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA.0020119
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0409464
OH
Enumeration date
07/08/2020
Last updated
06/23/2021
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