MEDICARE: DR. LAWRENCE A ROBILLARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	048817	GA
2	207V00000X	Obstetrics & Gynecology Physician	4301050507	MI
3	207V00000X	Obstetrics & Gynecology Physician	20666	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	SC83593365	OTHER	SC	MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396731790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE A ROBILLARD MD

Provider Business Mailing Address
First Line	:	PO BOX 743904
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-3904
Country	:	US
Telephone Number	:	803-296-7320
Fax Number	:	803-296-7330

Provider Business Practice Location Address
First Line	:	2 MEDICAL PARK RD STE 107
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-6839
Country	:	US
Telephone Number	:	803-434-4480
Fax Number	:	803-434-3340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	02/13/2024

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Directions to “ DR. LAWRENCE A ROBILLARD MD” Practice Location

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