Provider Demographics
NPI:1174503437
Name:PLANK, ROBIN L (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:L
Last Name:PLANK
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:100 INNOVATION DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-0000
Mailing Address - Country:US
Mailing Address - Phone:724-794-4023
Mailing Address - Fax:724-794-3675
Practice Address - Street 1:100 INNOVATION DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-0000
Practice Address - Country:US
Practice Address - Phone:724-794-4023
Practice Address - Fax:724-794-3675
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2011-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS010842L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH63125Medicare UPIN