Basic Information
| Provider Information | |||||||||
| NPI: | 1992799316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STONE | ||||||||
| FirstName: | ROBIN | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3410 COKESBURY RD | ||||||||
| Address2: | |||||||||
| City: | HODGES | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296539181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642272099 | ||||||||
| FaxNumber: | 8642271779 | ||||||||
| Practice Location | |||||||||
| Address1: | 3410 COKESBURY RD | ||||||||
| Address2: | |||||||||
| City: | HODGES | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296539181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642272099 | ||||||||
| FaxNumber: | 8642271779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2005 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 15625 | SC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | L10673 | 05 | SC | MEDICAID |