Jansen, Robert

Jansen, Robert is an individual health care provider with primary practice located at 823 82Nd Pkwy , Myrtle Beach SC 29572-4607. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Jansen, Robert can be contacted via phone (843) 449-1010.

Contact Information

Primary practice address
823 82Nd Pkwy Myrtle Beach SC 29572-4607
Phone: (843) 449-1010
Fax: (843) 497-6171
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Urology 208800000X MD36653 South Carolina

Profile Details

NPI number 1316180847
LBN Legal business name Jansen, Robert
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2009
Last updated May 1st, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316180847 NPPES
South Carolina Other 4789482 AETNA
South Carolina Other RR MEDICARE AETNA
South Carolina Other 1010218 AETNA
South Carolina MEDICAID 1316180847 AETNA
South Carolina MEDICAID 366534 AETNA

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