Provider Demographics
NPI:1841220878
Name:SZYPCZAK, ROBERT MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:SZYPCZAK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 CHARLESFORT PL
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1988
Mailing Address - Country:US
Mailing Address - Phone:843-540-2327
Mailing Address - Fax:
Practice Address - Street 1:104 BUCKWALTER PKWY
Practice Address - Street 2:UNIT 1 C
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4131
Practice Address - Country:US
Practice Address - Phone:843-757-9588
Practice Address - Fax:843-757-9589
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1335152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD13359Medicaid
SC5001335OtherDHEC
SC5001335OtherDHEC
SCD13359Medicaid
V03230Medicare UPIN
SC5001335OtherDHEC