Individual
JENNIFER L ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3009 WAUGHTOWN ST, WINSTON SALEM, NC 27107-1634
(336) 293-8728
(336) 448-5503
Mailing address
3009 WAUGHTOWN ST, WINSTON SALEM, NC 27107-1634
(336) 293-8728
(336) 448-5503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2012-01631
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921942
—
NC
Enumeration date
05/22/2008
Last updated
12/04/2017
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