Provider Demographics
NPI:1518175959
Name:CUSICK, ROBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:CUSICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 W 14TH ST STE 120
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6974
Mailing Address - Country:US
Mailing Address - Phone:480-695-1925
Mailing Address - Fax:480-675-5441
Practice Address - Street 1:6220 E OAK ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-1101
Practice Address - Country:US
Practice Address - Phone:460-675-5675
Practice Address - Fax:480-675-5441
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4749207ZB0001X
AZ40877207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine