Provider Demographics
NPI:1508856139
Name:ROBINSON, DONALD EDWIN (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:EDWIN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-893-6500
Mailing Address - Fax:423-893-6563
Practice Address - Street 1:6401 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:423-893-6500
Practice Address - Fax:423-893-6563
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000008784207R00000X
TNMD8784207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
408112101OtherRAILROAD MEDICARE
2003992OtherBLUE CROSS
2003992OtherBLUE CROSS
B03002Medicare UPIN
408112101OtherRAILROAD MEDICARE
TN3163380Medicare PIN