Provider Demographics
NPI:1437337359
Name:ROBBINS, CARLY BETH (DPM)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:BETH
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 DAMASCUS RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-5535
Mailing Address - Country:US
Mailing Address - Phone:937-578-4021
Mailing Address - Fax:379-578-4011
Practice Address - Street 1:388 DAMASCUS RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-5535
Practice Address - Country:US
Practice Address - Phone:937-578-4021
Practice Address - Fax:937-578-4011
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003475213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2850400Medicaid
OH4236723Medicare PIN
OH4236722Medicare PIN
OH2850400Medicaid
OHH126000Medicare PIN