Provider Demographics
NPI:1548244841
Name:ROBINSON, CORVIN (MD)
Entity Type:Individual
Prefix:
First Name:CORVIN
Middle Name:
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 1:13218 BROOKLANE DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-1435
Mailing Address - Country:US
Mailing Address - Phone:240-527-2082
Mailing Address - Fax:240-310-1927
Practice Address - Street 1:13218 BROOKLANE DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-1435
Practice Address - Country:US
Practice Address - Phone:240-527-2082
Practice Address - Fax:240-310-1927
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00448572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD00823OtherVALUE OPTIONS
MDD0044857OtherMEDICAL LICENSE
MDMDMCDMedicaid
MDSKMDOMedicaid
MDSX173OtherBEACON HEALTH
MD60054OtherAETNA
MDSB580OtherBLUE CROSS/BLUE SHIELD
MDSB580OtherBLUE CROSS/BLUE SHIELD
MD00823OtherVALUE OPTIONS