Healthcare Provider Details

I. General information

NPI: 1447244777
Provider Name (Legal Business Name): DAN W ROBINSON JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W GREENWOOD ST STE 1
ABBEVILLE SC
29620-5727
US

IV. Provider business mailing address

PO BOX 887
ABBEVILLE SC
29620-0887
US

V. Phone/Fax

Practice location:
  • Phone: 864-366-9681
  • Fax: 864-366-5600
Mailing address:
  • Phone: 864-366-5011
  • Fax: 864-366-3317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14646
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: