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Individual

DR. ROBERT T. WHITAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7941 BROAD RIVER RD, IRMO, SC 29063-2358
(803) 252-1816
(803) 252-9132
Mailing address
601 CLEMSON RD, COLUMBIA, SC 29229-4341
(803) 788-6146
(803) 462-0312

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18808
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
188086
SC
Enumeration date
11/28/2005
Last updated
07/12/2019
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