Provider Demographics
NPI:1164504411
Name:ROBINSON, ANITA E (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:E
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 LINCOLN WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2476
Mailing Address - Country:US
Mailing Address - Phone:208-765-4440
Mailing Address - Fax:208-667-7062
Practice Address - Street 1:1607 LINCOLN WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2476
Practice Address - Country:US
Practice Address - Phone:208-765-4440
Practice Address - Fax:208-667-7062
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM3977207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002499500Medicaid
C47831Medicare UPIN
1370105Medicare PIN