Individual
DR. ROBERT SCOTT LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2097 HENRY TECKLENBURG DR STE 201W, CHARLESTON, SC 29414-5739
(843) 402-1211
(843) 606-8088
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22236
SC
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
22236
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222360
—
SC
01
—
P00269321
RR MEDICARE
—
01
—
P00727226
RAILROAD MEDICARE ID-RSFPP
SC
Enumeration date
06/11/2006
Last updated
06/11/2025
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