Provider Demographics
NPI:1235826181
Name:ROBINSON, MATTHEW ANDREW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ANDREW
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 LEVERETTE ST
Mailing Address - Street 2:
Mailing Address - City:MARNE
Mailing Address - State:MI
Mailing Address - Zip Code:49435-9767
Mailing Address - Country:US
Mailing Address - Phone:616-438-5704
Mailing Address - Fax:
Practice Address - Street 1:4406 LEVERETTE ST
Practice Address - Street 2:
Practice Address - City:MARNE
Practice Address - State:MI
Practice Address - Zip Code:49435-9767
Practice Address - Country:US
Practice Address - Phone:616-438-5704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302415015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist