Provider Demographics
NPI:1255180014
Name:ROBINSON, EDWARD G (INDEPENDENT PROVIDER)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:G
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12020 CONTINENTAL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2918
Mailing Address - Country:US
Mailing Address - Phone:216-326-9320
Mailing Address - Fax:
Practice Address - Street 1:12020 CONTINENTAL AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2918
Practice Address - Country:US
Practice Address - Phone:216-326-9320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant