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NPI Code Detail

MEDICARE: ROBERT KARL HETZ DO

MEDICARE: ROBERT KARL HETZ DO
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
1207Q00000XFamily Medicine Physician028007GA
2207Q00000XFamily Medicine Physician1245SC

General Provider Information

NPI Number : 1831175165
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT KARL HETZ DO
Provider Business Mailing Address
First Line : PO BOX 749306
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9306
Country : US
Telephone Number : 843-568-7129
Fax Number : 843-760-6988
Provider Business Practice Location Address
First Line : 8091 RIVERS AVE
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9236
Country : US
Telephone Number : 843-572-7000
Fax Number : 843-572-4070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 11/03/2024

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