Provider Demographics
NPI:1942296090
Name:ROBLE, ARLENE GRACE (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:GRACE
Last Name:ROBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:440-282-7408
Mailing Address - Fax:440-960-2214
Practice Address - Street 1:590 N LEAVITT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1131
Practice Address - Country:US
Practice Address - Phone:440-282-7408
Practice Address - Fax:440-960-2214
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-084456208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2524021Medicaid
I20469Medicare UPIN
OH2524021Medicaid