Provider Demographics
NPI:1780862128
Name:KEVIN B. ROBINSON, MD, PC
Entity Type:Organization
Organization Name:KEVIN B. ROBINSON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:BARTEL
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-790-3669
Mailing Address - Street 1:5889 BAY RD
Mailing Address - Street 2:SUITE #105
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2540
Mailing Address - Country:US
Mailing Address - Phone:989-790-3669
Mailing Address - Fax:989-790-4945
Practice Address - Street 1:5889 BAY RD
Practice Address - Street 2:SUITE #105
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2540
Practice Address - Country:US
Practice Address - Phone:989-790-3669
Practice Address - Fax:989-790-4945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064676207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4090580Medicaid
MI4090580Medicaid
MIF96181Medicare UPIN