Provider Demographics
NPI:1093775926
Name:BRITANISKY, ROBERT G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:BRITANISKY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:391 SERPENTINE DR
Mailing Address - Street 2:SUITE500
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3096
Mailing Address - Country:US
Mailing Address - Phone:864-585-8221
Mailing Address - Fax:864-216-4290
Practice Address - Street 1:391 SERPENTINE DR.
Practice Address - Street 2:SUITE500
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3083
Practice Address - Country:US
Practice Address - Phone:864-585-8221
Practice Address - Fax:864-216-4290
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2016-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC19834208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT39580Medicaid
SCG029374300Medicare PIN
SCG02937Medicare UPIN