Roberts, Mark D

Roberts, Mark D is an individual health care provider with primary practice located at 2845 E Highway 76 Suite 4, Mullins SC 29574-6037. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Roberts, Mark D can be contacted via phone (843) 431-2720.

Contact Information

Primary practice address
2845 E Highway 76 Suite 4 Mullins SC 29574-6037
Phone: (843) 431-2720
Fax: (843) 431-2726
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 28818 South Carolina

Profile Details

NPI number 1871507913
LBN Legal business name Roberts, Mark D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Oct 15th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871507913 NPPES
South Carolina Other GP5462 MEDICAID GROUP
South Carolina MEDICAID 288183 MEDICAID GROUP
South Carolina MEDICAID RHC538 MEDICAID GROUP
South Carolina MEDICAID GP0861 MEDICAID GROUP

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