Provider Demographics
NPI:1043262561
Name:CARTLEDGE, ROBERT BRUNSON JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUNSON
Last Name:CARTLEDGE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:255 ENTERPRISE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3530
Practice Address - Country:US
Practice Address - Phone:864-454-8120
Practice Address - Fax:644-548-1258
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23470208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00102689OtherRR MEDICARE
SC234703Medicaid
SC576007863095OtherBCBS OF SC
SCH82050Medicare UPIN
SC234703Medicaid
SCH820503640Medicare PIN