Provider Demographics
NPI:1053310011
Name:BERAN, ROBIN FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:FRANCIS
Last Name:BERAN
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 1:6357 N HAMILTON ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081
Mailing Address - Country:US
Mailing Address - Phone:614-939-1600
Mailing Address - Fax:614-939-0585
Practice Address - Street 1:6357 N HAMILTON RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-939-1600
Practice Address - Fax:614-939-0585
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051085207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000348862OtherANTHEM INS CO
OHP00174303OtherRAILROAD MEDICARE
OHA15832Medicare UPIN
OHP00174303OtherRAILROAD MEDICARE