Individual
KENNETH ROBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1385 MEDICAL CENTER DR, ROANOKE RAPIDS, NC 27870-5130
(252) 537-9176
(252) 537-6851
Mailing address
1385 MEDICAL CENTER DR, ROANOKE RAPIDS, NC 27870-5130
(252) 537-9176
(252) 537-6851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
117385
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89134RY
—
NC
Enumeration date
03/30/2006
Last updated
01/18/2022
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