Provider Demographics
NPI:1033377577
Name:UNDERHILL, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:UNDERHILL
Suffix:
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 1:6593 N OMIGISI BEACH RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49670-9323
Mailing Address - Country:US
Mailing Address - Phone:231-386-7203
Mailing Address - Fax:231-386-5720
Practice Address - Street 1:6593 N OMIGISI BEACH RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:MI
Practice Address - Zip Code:49670-9323
Practice Address - Country:US
Practice Address - Phone:231-386-7203
Practice Address - Fax:231-386-5720
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-31
Last Update Date:2008-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010239222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry