Provider Demographics
NPI:1609864057
Name:ROBBINS, SOLOMON (MD)
Entity Type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:
Last Name:ROBBINS
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 1:5400 OLD COURT RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5100
Mailing Address - Country:US
Mailing Address - Phone:410-521-3121
Mailing Address - Fax:410-521-3191
Practice Address - Street 1:5400 OLD COURT RD
Practice Address - Street 2:SUITE 206
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5100
Practice Address - Country:US
Practice Address - Phone:410-521-3121
Practice Address - Fax:410-521-3191
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0009601174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD054941000Medicaid
MDD74793Medicare UPIN
MD7097Medicare PIN