Provider Demographics
NPI:1013134857
Name:ROBINSON, ANGELA BYUN (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:BYUN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:YOUNGMEE
Other - Last Name:BYUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # R3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-5801
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # R2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1716
Practice Address - Country:US
Practice Address - Phone:216-444-5801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-095435208000000X
390200000X
OH35.0954352080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026872770001Medicaid
OH3071965Medicaid
PA1026872770001Medicaid