Provider Demographics
NPI:1417029364
Name:ROBINSON, CYNANE (DO)
Entity Type:Individual
Prefix:DR
First Name:CYNANE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16250 NORTHLAND DR
Mailing Address - Street 2:SUITE 312
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5228
Mailing Address - Country:US
Mailing Address - Phone:248-336-2850
Mailing Address - Fax:248-336-2852
Practice Address - Street 1:16250 NORTHLAND DR
Practice Address - Street 2:SUITE 312
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5228
Practice Address - Country:US
Practice Address - Phone:248-336-2850
Practice Address - Fax:248-336-2852
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011774207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4091433 11Medicaid
MI015820589OtherBCBSM PROVIDER NUMBER
MIP16080001Medicare PIN
MI015820589OtherBCBSM PROVIDER NUMBER