Provider Demographics
NPI:1679566293
Name:PLATTENBERGER-GILMORE, ROBIN I (DO)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:I
Last Name:PLATTENBERGER-GILMORE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:I
Other - Last Name:PLATTENBERGER-GILMORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:400 E POLK ST
Mailing Address - Street 2:POB 909
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-1237
Mailing Address - Country:US
Mailing Address - Phone:319-653-6601
Mailing Address - Fax:319-653-5624
Practice Address - Street 1:400 E POLK ST
Practice Address - Street 2:POB 909
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1237
Practice Address - Country:US
Practice Address - Phone:319-653-6601
Practice Address - Fax:319-653-5624
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6111476Medicaid
IA6111476Medicaid
IAG11140Medicare UPIN