Provider Demographics
NPI:1942319090
Name:BLITZ, ROBIN K (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:K
Last Name:BLITZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1919 E THOMAS RD
Mailing Address - Street 2:BLDG 2108, SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7710
Mailing Address - Country:US
Mailing Address - Phone:602-512-8029
Mailing Address - Fax:602-512-8161
Practice Address - Street 1:1919 E THOMAS
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016
Practice Address - Country:US
Practice Address - Phone:602-933-0066
Practice Address - Fax:602-933-0068
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ238202080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE20308Medicare UPIN