MEDICARE: DR. ROBERT LOPANIK O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	537	SC
2	152WC0802X	Corneal and Contact Management Optometrist	537	SC
3	152WS0006X	Sports Vision Optometrist	537	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	537	OTHER	SC	SC LICENSE NUMBER

General Provider Information

NPI Number	:	1093878001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT LOPANIK O.D.

Provider Business Mailing Address
First Line	:	112 RUTLEDGE AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29401-1333
Country	:	US
Telephone Number	:	843-577-2674
Fax Number	:	843-577-5170

Provider Business Practice Location Address
First Line	:	112 RUTLEDGE AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29401-1333
Country	:	US
Telephone Number	:	843-577-2674
Fax Number	:	843-577-5170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	09/11/2025

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