Individual
ALFRED MACK ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5615 HIGH ST W, SUITE A, PORTSMOUTH, VA 23703-3758
(757) 484-5002
(757) 483-9506
Mailing address
5615 HIGH ST W, SUITE A, PORTSMOUTH, VA 23703-3758
(757) 484-5002
(757) 483-9506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101030378
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5624495
—
VA
Enumeration date
04/14/2006
Last updated
11/05/2008
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