Individual
ROBERT GLEN QUATTLEBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
885 TIGER BLVD, CLEMSON, SC 29631-1480
(864) 512-7257
(864) 654-3261
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 512-7257
(864) 654-3261
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27937
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279371
—
SC
01
—
P00638301
RAILROAD MEDICARE ID
SC
Enumeration date
10/13/2006
Last updated
02/16/2023
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