Healthcare Provider Details

I. General information

NPI: 1215067152
Provider Name (Legal Business Name): DAVID WAYNE ROBINSON JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5070 INTERNATIONAL BLVD STE 131
N CHARLESTON SC
29418-6007
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-402-5053
  • Fax: 843-724-1325
Mailing address:
  • Phone: 888-472-0043
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18868
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: