Provider Demographics
NPI:1699031831
Name:B ROBERT TROTTER MD LLC
Entity Type:Organization
Organization Name:B ROBERT TROTTER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:TROTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-681-9355
Mailing Address - Street 1:18 HOSPITAL CENTER BLVD
Mailing Address - Street 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:843-842-9700
Practice Address - Street 1:18 HOSPITAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2733
Practice Address - Country:US
Practice Address - Phone:843-681-9355
Practice Address - Fax:843-842-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty