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General NPI Number Information
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NPI Number | 1952745499
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Entity Type | Individual
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Provider Name | MR. ROBERT ADAM GREEN
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Gender | Male
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Dates
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Enumeration Date | 04/27/2013
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 2720 SUNSET BLVD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4810
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Country | US
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Telephone | 803-935-8538
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Fax | 803-791-2660
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Provider Business Mailing Address
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Address Line | 879 NORTHWICH AVE
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City | WESTFIELD
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State | IN
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Zip | 46074-3344
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Country | US
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Telephone | 870-926-5519
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 31768
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28221931A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R079312
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2013012833
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License Number State | MO
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