Organization
ROBESON MEDICAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDHYA ANNE THOMASMONTILUS M.D. (CEO)
(910) 738-2330
Entity
Organization
Contact information
Practice address
4320 FAYETTEVILLE RD, SUITE A, LUMBERTON, NC 28358-2706
(910) 738-2330
(910) 738-1403
Mailing address
4320 FAYETTEVILLE RD, SUITE A, LUMBERTON, NC 28358-2706
(910) 738-2330
(910) 738-1403
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9701618
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0226C
BC/BS PROVIDER #
NC
05
—
89-0226C
—
NC
Enumeration date
09/25/2006
Last updated
09/14/2011
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