1952558892 NPI number — MR. CHRISTOPHER CHAD ROBINSON PA

Table of content: MR. CHRISTOPHER CHAD ROBINSON PA (NPI 1952558892)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952558892 NPI number — MR. CHRISTOPHER CHAD ROBINSON PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
CHRISTOPHER
Provider Middle Name:
CHAD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952558892
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 262
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANDERSON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29622-0262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-512-2425
Provider Business Mailing Address Fax Number:
864-512-2379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
125 DOUGHTY ST
Provider Second Line Business Practice Location Address:
STE 280
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29403-5736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-958-1281
Provider Business Practice Location Address Fax Number:
843-958-1278
Provider Enumeration Date:
08/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AS0400X , with the licence number:  1357 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1206PA , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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