Individual
ROBERT JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
823 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-1010
(843) 497-6171
Mailing address
823 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-1010
(843) 497-6171
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD36653
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1010218
WELLCARE
SC
05
—
1316180847
—
NC
05
—
366534
—
SC
01
—
4789482
AETNA
SC
01
—
RR MEDICARE
P01378093
SC
Enumeration date
04/14/2009
Last updated
04/30/2026
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