Provider Demographics
NPI:1932166808
Name:ROBINSON, DAVID GLEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GLEN
Last Name:ROBINSON
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 1:270 E STATE ST
Mailing Address - Street 2:SUITE G100
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4957
Mailing Address - Country:US
Mailing Address - Phone:330-821-4869
Mailing Address - Fax:330-821-6358
Practice Address - Street 1:270 E STATE ST
Practice Address - Street 2:SUITE G100
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4957
Practice Address - Country:US
Practice Address - Phone:330-821-4869
Practice Address - Fax:330-821-6358
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045123R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0517766Medicaid
OH0517766Medicaid
OHRO0535531Medicare ID - Type Unspecified