Provider Demographics
NPI:1578697934
Name:SOUTH, ROBERT CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:SOUTH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 CAPITOL TRL
Mailing Address - Street 2:SUITE #103
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5700
Mailing Address - Country:US
Mailing Address - Phone:302-998-2927
Mailing Address - Fax:302-224-3730
Practice Address - Street 1:1450 CAPITOL TRL
Practice Address - Street 2:SUITE #103
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5700
Practice Address - Country:US
Practice Address - Phone:302-998-2927
Practice Address - Fax:302-224-3730
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE7581182Medicare UPIN
DE002025Medicare ID - Type Unspecified
DEP00242070Medicare UPIN