Provider Demographics
NPI:1750815528
Name:ROBERTS, HANNAH MARIE (MD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:DEVOID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15 YORKSHIRE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-7785
Mailing Address - Country:US
Mailing Address - Phone:828-274-1600
Mailing Address - Fax:828-274-1603
Practice Address - Street 1:15 YORKSHIRE ST STE 201
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-7785
Practice Address - Country:US
Practice Address - Phone:828-274-1600
Practice Address - Fax:828-274-1603
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-02131207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1750815528Medicaid
NCPENDINGOtherMEDICARE PTAN