Active NPI
Robert M Poiletman, M.D.
- Neurology Physician
- Columbia, SC
National Provider Identifier
1841202942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 10059
- Practice address
- 1800 Colonial Dr
Columbia, SC 29203-6827 - Phone
- (803) 898-8405
- Fax
- (808) 898-8526
- NPI assigned
- Aug 13, 2006
- Last updated
- Oct 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 10059 | SC | Primary |
Addresses
Primary practice location
1800 Colonial Dr
Columbia, SC 29203-6827
Mailing address
PO Box 485
Columbia, SC 29202-0485
Phone (803) 898-8405
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100599 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- robert.poiletman.p1@direct.scdc.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1841202942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 485",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292020485",
"telephone_number": "803-898-8405",
"fax_number": "808-898-8526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 COLONIAL DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036827",
"telephone_number": "803-898-8405",
"fax_number": "808-898-8526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POILETMAN",
"first_name": "ROBERT",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "SC",
"license": "10059",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100599",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.