Healthcare Provider Details

I. General information

NPI: 1275063745
Provider Name (Legal Business Name): ROBERT DUSTIN RAWLINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 E HOSPITAL DR STE 400
WEST COLUMBIA SC
29169-4800
US

IV. Provider business mailing address

PO BOX 6069
WEST COLUMBIA SC
29171-6069
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-3300
  • Fax: 803-936-7735
Mailing address:
  • Phone: 803-936-3300
  • Fax: 803-936-7735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD94224
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number91916
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number91916
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: