Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 15536 | SC |
NPI | 1093795353 |
---|---|
Provider Name | Dr. Robert D Hubbird |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203-6873 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 16/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
155361 | (05) | SC |
C17152 | (02) | SC |