Individual
DR. BRIAN J ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
823 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-1010
(843) 497-6171
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPT, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD20257
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340015092
RAILROAD MEDICARE
SC
05
—
6906029
—
NC
01
—
775189
WELLCARE
SC
01
—
80023046
SELECT HEALTH
SC
05
—
GP1418
—
SC
05
—
GP4522
—
SC
01
—
P00360566
RAILROAD MEDICARE
SC
Enumeration date
11/04/2005
Last updated
12/29/2016
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