Healthcare Provider Details

I. General information

NPI: 1710849021
Provider Name (Legal Business Name): ROBERT KORBOI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 8TH DIVISION RD
COLUMBIA SC
29207-5700
US

IV. Provider business mailing address

5027 HOXTON TRL
COLUMBIA SC
29209-5163
US

V. Phone/Fax

Practice location:
  • Phone: 803-751-0486
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: