Provider Demographics
NPI:1386683373
Name:DEVINE, ROBIN CAMMAROTA (DO)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:CAMMAROTA
Last Name:DEVINE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:C
Other - Last Name:DEVINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:5350 FRANTZ RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4850 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3194
Practice Address - Country:US
Practice Address - Phone:614-566-0950
Practice Address - Fax:614-566-0766
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.006924207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2292639Medicaid
OH0109744OtherUNITED HEALTHCARE OF OHIO
OH000000271884OtherANTHEM BC/BS
H42317Medicare UPIN
OH0109744OtherUNITED HEALTHCARE OF OHIO
OHDE4055252Medicare ID - Type Unspecified