| NPI | 1114635174 |
|---|---|
| Former Legal Business Name | SANFORD E ROBERTS III MD, INC. |
| Entity Type | Organization |
| Authorized Contact | BRANTLEY TILMAN JOLLY President 703-447-6897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 163WC2100X Registered Nurse, Continence Care |
| 163WE0900X Registered Nurse, Enterostomal Therapy | |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2023-07-18 |