Healthcare Provider Details

I. General information

NPI: 1952558892
Provider Name (Legal Business Name): CHRISTOPHER CHAD ROBINSON PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DOUGHTY ST STE 280
CHARLESTON SC
29403-5736
US

IV. Provider business mailing address

PO BOX 262
ANDERSON SC
29622-0262
US

V. Phone/Fax

Practice location:
  • Phone: 843-958-1281
  • Fax: 843-958-1278
Mailing address:
  • Phone: 864-512-2425
  • Fax: 864-512-2379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1357
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: