Provider Demographics
NPI:1033215918
Name:SIMS, ROBERT NMN (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:NMN
Last Name:SIMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9150 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206
Mailing Address - Country:US
Mailing Address - Phone:313-895-6605
Mailing Address - Fax:313-895-6530
Practice Address - Street 1:9150 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206
Practice Address - Country:US
Practice Address - Phone:313-895-6605
Practice Address - Fax:313-895-6530
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101005314207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI71020005821789OtherBCS
MI5821789Medicare ID - Type Unspecified
MI71020005821789OtherBCS