Healthcare Provider Details

I. General information

NPI: 1376447425
Provider Name (Legal Business Name): MARTIA ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 W MONTAGUE AVE
NORTH CHARLESTON SC
29418-6090
US

IV. Provider business mailing address

243 SWEET CHERRY LN
SUMMERVILLE SC
29486-8142
US

V. Phone/Fax

Practice location:
  • Phone: 305-772-8358
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: