Basic Information
| Provider Information | |||||||||
| NPI: | 1386883973 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBISON | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E MCBEE AVE FL 4 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296012842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645226603 | ||||||||
| FaxNumber: | 8284329833 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 GROVE RD FL 5 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296054210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644554411 | ||||||||
| FaxNumber: | 8644554480 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2009 | ||||||||
| LastUpdateDate: | 06/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OT012776 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 54777 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 1565 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 2016-01024 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 1565 | SC | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | SCG760 | 01 | SC | MEDICARE | OTHER | 015655 | 05 | SC | MEDICAID | 1386883973 | 05 | NC | MEDICAID |