Provider Demographics
NPI:1467299115
Name:STRUBLE, ROBERT BRYAN III (SRNA)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BRYAN
Last Name:STRUBLE
Suffix:III
Gender:M
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1190 ARUBA CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8643
Mailing Address - Country:US
Mailing Address - Phone:404-825-3435
Mailing Address - Fax:
Practice Address - Street 1:1190 ARUBA CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-8643
Practice Address - Country:US
Practice Address - Phone:404-825-3435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN284002367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered