Individual
SHERVON STOUTAMIRE ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 PROVIDENCE RD, SUITE 101, CHARLOTTE, NC 28207-1468
(704) 749-5800
(704) 749-5819
Mailing address
200 PROVIDENCE RD, SUITE 101, CHARLOTTE, NC 28207-1468
(704) 749-5800
(704) 749-5819
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-02508
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194PA
—
SC
01
—
164W4
BCBS NC
NC
01
—
P00986388
RR MEDICARE
NC
Enumeration date
12/03/2010
Last updated
11/28/2012
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