Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 537 | SC |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 537 | SC |
N | 152WS0006X | Sports Vision | 537 | SC |
NPI | 1093878001 |
---|---|
Provider Name | Dr. Robert Lopanik |
First Address | Charleston, SC 29401-1333 |
Second Address | Charleston, SC 29401-1333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
537 | SC LICENSE NUMBER (01) | SC |
D00537 | (05) | SC |
U23554 | (02) | SC |