Provider Demographics
NPI:1619094950
Name:ROBINSON, WILLIAM A
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 E. 10 MILE RD.
Mailing Address - Street 2:STE. 104
Mailing Address - City:CENTER LINE
Mailing Address - State:MI
Mailing Address - Zip Code:48015
Mailing Address - Country:US
Mailing Address - Phone:586-754-3511
Mailing Address - Fax:586-757-2977
Practice Address - Street 1:8033 E 10 MILE RD
Practice Address - Street 2:STE. 104
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1427
Practice Address - Country:US
Practice Address - Phone:586-754-3511
Practice Address - Fax:586-757-2977
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBR3501001102237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI383076720OtherEMPLOYER ID
MI0E02601OtherHAP ID
MI540E00414OtherBCBSM PROVIDER ID
MI540E00414OtherBLUE CARE NETWORK ID