Provider Demographics
NPI:1013060573
Name:PAYNE, ROBERT H (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:PAYNE
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 1:4 CARRIAGE LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6048
Mailing Address - Country:US
Mailing Address - Phone:843-763-2222
Mailing Address - Fax:843-766-5705
Practice Address - Street 1:4 CARRIAGE LN
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6048
Practice Address - Country:US
Practice Address - Phone:843-763-2222
Practice Address - Fax:843-766-5705
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6767106H00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC067670Medicaid
SCP00443329OtherRR MEDICARE
SCC60728Medicare UPIN
SC067670Medicaid