Provider Demographics
NPI:1275539595
Name:POHL, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:POHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:123 S MAIN ST
Mailing Address - Street 2:STE 270
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2635
Mailing Address - Country:US
Mailing Address - Phone:248-586-0123
Mailing Address - Fax:248-591-9104
Practice Address - Street 1:123 S MAIN ST
Practice Address - Street 2:STE 270
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2635
Practice Address - Country:US
Practice Address - Phone:248-586-0123
Practice Address - Fax:248-591-9104
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010336582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
06330989261Medicare ID - Type Unspecified
MIB-47671Medicare UPIN