Provider Demographics
NPI:1376577767
Name:ROBINSON, HOLLY A (MD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:A
Other - Last Name:SILLINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-777-6435
Mailing Address - Fax:317-777-6644
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-274-2617
Practice Address - Fax:317-278-2587
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049246208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2439627000OtherPASSPORT ADVANTAGE
370016392OtherMEDICARE RAILROAD
700254OtherFEDERAL BLACK LUNG
KY64015860Medicaid
KY1161921Medicaid
IN200257520AMedicaid
IN000000174336OtherANTHEM BCBS
KY1161921OtherPASSPORT KENTUCKY
IN410029POtherSIHO
7518123OtherAETNA
IN000000174336OtherANTHEM BCBS
700254OtherFEDERAL BLACK LUNG
KY2439627000OtherPASSPORT ADVANTAGE
IN412840CCMedicare PIN