Provider Demographics
NPI:1811093289
Name:ROBBINS, ROSEMARY (MD)
Entity type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14701 DETROIT AVE
Mailing Address - Street 2:SUITE 522
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4115
Mailing Address - Country:US
Mailing Address - Phone:216-228-3232
Mailing Address - Fax:216-228-7507
Practice Address - Street 1:14701 DETROIT AVE
Practice Address - Street 2:SUITE 522
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4115
Practice Address - Country:US
Practice Address - Phone:216-228-3232
Practice Address - Fax:216-228-7507
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-1899208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2146378Medicaid