Individual
VICKI S ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
3574 SUNSET BLVD, WEST COLUMBIA, SC 29169-3044
(803) 796-2500
(803) 796-4378
Mailing address
3574 SUNSET BLVD, WEST COLUMBIA, SC 29169-3044
(803) 796-2500
(803) 796-4378
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A609D
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0301242
CAROLINA CARE PLAN
SC
05
—
PA1426
—
SC
Enumeration date
03/10/2006
Last updated
01/17/2012
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