Healthcare Provider Details

I. General information

NPI: 1992286876
Provider Name (Legal Business Name): WILLIAM GRAHAM ROBINSON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 HARRISON BRIDGE RD STE 200
SIMPSONVILLE SC
29680-7133
US

IV. Provider business mailing address

525 VERDAE BLVD STE 200
GREENVILLE SC
29607-4021
US

V. Phone/Fax

Practice location:
  • Phone: 864-272-0388
  • Fax: 864-213-9237
Mailing address:
  • Phone: 864-272-0388
  • Fax: 864-213-9237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22143
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: