Individual
VICTORIA ANDERSON ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
104 ELLETT RD, CHAPIN, SC 29036-8604
(803) 941-8095
Mailing address
104 ELLETT RD, CHAPIN, SC 29036-8604
(803) 941-8095
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4238PA
—
SC
Enumeration date
10/18/2019
Last updated
04/11/2022
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