Provider Demographics
NPI:1700908258
Name:SHRINER, ROBERT PURCELL
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PURCELL
Last Name:SHRINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 CHAPMAN DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6877
Mailing Address - Country:US
Mailing Address - Phone:330-676-1196
Mailing Address - Fax:
Practice Address - Street 1:4104 CHAPMAN DR
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-6877
Practice Address - Country:US
Practice Address - Phone:330-676-1196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRL250898172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver