Provider Demographics
NPI:1376507962
Name:ROBINE, ROBERT J (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:ROBINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 LITTLE BLUE PKWY
Mailing Address - Street 2:SUITE300
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-8312
Mailing Address - Country:US
Mailing Address - Phone:816-353-2700
Mailing Address - Fax:816-795-7311
Practice Address - Street 1:4200 LITTLE BLUE PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-8312
Practice Address - Country:US
Practice Address - Phone:816-353-2700
Practice Address - Fax:816-795-7311
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR7N58207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
L160000Medicare ID - Type UnspecifiedPROVIDER ID
E81833Medicare UPIN