Provider Demographics
NPI:1912925215
Name:MARGOLIS, ROBERT MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:MARGOLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HILLSIDE CT
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2745
Mailing Address - Country:US
Mailing Address - Phone:937-836-5356
Mailing Address - Fax:937-836-3420
Practice Address - Street 1:50 HILLSIDE CT
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2745
Practice Address - Country:US
Practice Address - Phone:937-836-5356
Practice Address - Fax:937-836-3420
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-6426-M207RP1001X, 207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0655830Medicaid
000000718372OtherBCBS -OH
OH0655830Medicaid
000000718372OtherBCBS -OH
OH0597242Medicare PIN
OHC03190Medicare UPIN