Provider Demographics
NPI:1255569430
Name:STAHL, ROBIN D (RD, CD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:STAHL
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7526 E 82ND ST STE 150
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1492
Mailing Address - Country:US
Mailing Address - Phone:317-585-1060
Mailing Address - Fax:
Practice Address - Street 1:7526 E 82ND ST STE 150
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1492
Practice Address - Country:US
Practice Address - Phone:317-585-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37000422A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered