Provider Demographics
NPI:1851312243
Name:ROBERTSON, CHERYL REIS (MD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:REIS
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 RANDOLPH RD STE 600
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1198
Mailing Address - Country:US
Mailing Address - Phone:704-342-0252
Mailing Address - Fax:980-533-7806
Practice Address - Street 1:1918 RANDOLPH RD STE 600
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1198
Practice Address - Country:US
Practice Address - Phone:704-342-0252
Practice Address - Fax:980-533-7801
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34141207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC660003566OtherMEDICARE-RR
SCN34141Medicaid
NC1851312243Medicaid
NC72287OtherBCBSNC
NC8972287Medicaid
NC8972287Medicaid
NC72287OtherBCBSNC
NC2164609JMedicare PIN