Provider Demographics
NPI:1114994969
Name:ROBINSON, WILLIAM K (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:K
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 402145
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-2145
Mailing Address - Country:US
Mailing Address - Phone:803-296-7305
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:3000 NE MEDICAL PARK
Practice Address - Street 2:SUITE 108
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6251
Practice Address - Country:US
Practice Address - Phone:803-462-9200
Practice Address - Fax:803-699-1474
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9085207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC090859Medicaid
SCC61338Medicare UPIN
SC090859Medicaid