Provider Demographics
NPI:1639354079
Name:ROBINSON, KRISTINE SWINTON (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:SWINTON
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:SWINTON
Other - Last Name:MAGABO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:26 HANNA LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-8063
Mailing Address - Country:US
Mailing Address - Phone:570-854-9310
Mailing Address - Fax:
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:570-854-9310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23811207P00000X
PAMD433234207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102406803Medicaid
PA1024068030001Medicaid
WV3810016697Medicaid
PA168084NJRMedicare PIN
WVWV2552BMedicare PIN
PA102406803Medicaid