Provider Demographics
NPI:1689725871
Name:ROBERTS, STEPHEN H
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:H
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 DAVIDSON DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4351
Mailing Address - Country:US
Mailing Address - Phone:704-786-9297
Mailing Address - Fax:704-793-1388
Practice Address - Street 1:823 DAVIDSON DR NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4351
Practice Address - Country:US
Practice Address - Phone:704-786-9297
Practice Address - Fax:704-793-1388
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1092237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1092OtherLICENSE NUMBER