Individual
MRS. SAMURDHI JAYAWEERA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3885 W ASHLEY CIR STE F600, CHARLESTON, SC 29414-9273
(843) 402-1360
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3822
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4854PA
—
SC
Enumeration date
02/23/2010
Last updated
05/19/2023
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