Provider Demographics
NPI:1508001397
Name:ROBINSON, MARY ANNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MARY ANNE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 KINGS HWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1772
Mailing Address - Country:US
Mailing Address - Phone:302-644-6400
Mailing Address - Fax:302-644-6404
Practice Address - Street 1:750 KINGS HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1772
Practice Address - Country:US
Practice Address - Phone:302-644-6400
Practice Address - Fax:302-644-6404
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003782363AM0700X
DEC5-0000947363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical