Provider Demographics
NPI:1659354579
Name:DHEIN, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:DHEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 DOUGHTY STREET
Mailing Address - Street 2:SUITE 420
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403
Mailing Address - Country:US
Mailing Address - Phone:843-723-3441
Mailing Address - Fax:843-805-4040
Practice Address - Street 1:125 DOUGHTY ST
Practice Address - Street 2:SUITE 420
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5736
Practice Address - Country:US
Practice Address - Phone:843-723-3441
Practice Address - Fax:843-805-4040
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI39628-020207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31760400Medicaid
050046595OtherRAIL ROAD MEDICARE
WI0002-68670Medicare ID - Type UnspecifiedPROVIDER NUMBER
WI31760400Medicaid
WI0001-68131Medicare ID - Type UnspecifiedPROVIDER NUMBER