Basic Information
| Provider Information | |||||||||
| NPI: | 1205168960 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DREW | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1710 LOTUS LN | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294129653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039820162 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2233 NORTHWOODS BLVD. | ||||||||
| Address2: | ROPER NORTHWOODS EMERGENCY DEPARTMENT | ||||||||
| City: | NORTH CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438248733 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2010 | ||||||||
| LastUpdateDate: | 02/05/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.