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Individual

ROBERT CONVERSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAA

Contact information

Practice address
2095 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5733
(843) 402-1436
(843) 402-1833
Mailing address
PO BOX 603484, CHARLOTTE, NC 28260-3484
(803) 765-1838
(803) 765-1732

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75
SC
367H00000X
Anesthesiologist Assistant
ANT.0000072
CO

Other

Enumeration date
01/02/2017
Last updated
05/10/2024
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