Provider Demographics
NPI:1568410280
Name:HANLIN, ROBERT BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUCE
Last Name:HANLIN
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 1:101 ORCHARD PARK DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3531
Mailing Address - Country:US
Mailing Address - Phone:864-729-6606
Mailing Address - Fax:855-617-4426
Practice Address - Street 1:101 ORCHARD PARK DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3531
Practice Address - Country:US
Practice Address - Phone:864-729-6606
Practice Address - Fax:855-617-4426
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC80130814OtherRR MEDICARE
SC171771Medicaid
SCB307787951Medicare PIN
SCB30778Medicare UPIN
SC80130814OtherRR MEDICARE