Provider Demographics
NPI:1407964943
Name:SCHUBERT, ROBERT L III (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:SCHUBERT
Suffix:III
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 1:8 LAFAYETTE PLACE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2733
Mailing Address - Country:US
Mailing Address - Phone:843-681-9355
Mailing Address - Fax:843-842-9701
Practice Address - Street 1:8 LAFAYETTE PL STE 2
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2278
Practice Address - Country:US
Practice Address - Phone:843-681-9355
Practice Address - Fax:843-842-9701
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28567207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080135996OtherRRR
01-41197OtherUNITED HEALTHCARE
5486638OtherAETNA
62173865901OtherJOHN DEERE
100010427OtherPHP TENNCARE
TN3096395OtherBCBS
080135996OtherRRR
3821951Medicare ID - Type Unspecified