Individual
MR. MARK A ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 BARNWELL AVE NW, AIKEN, SC 29801
(803) 644-4403
(803) 644-4405
Mailing address
415 BARNWELL AVE NW, AIKEN, SC 29801
(803) 644-4403
(803) 644-4405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
020863
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020863
MED BD LLR
SC
05
—
T38368
—
SC
Enumeration date
10/27/2006
Last updated
01/30/2018
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