1205055415 NPI number — WILLIAM A. ROBINSON, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205055415 NPI number — WILLIAM A. ROBINSON, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM A. ROBINSON, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205055415
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8033 E 10 MILE RD
Provider Second Line Business Mailing Address:
STE. 104
Provider Business Mailing Address City Name:
CENTER LINE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48015-1427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-754-3511
Provider Business Mailing Address Fax Number:
586-757-2977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8033 E 10 MILE RD
Provider Second Line Business Practice Location Address:
STE. 104
Provider Business Practice Location Address City Name:
CENTER LINE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48015-1427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-754-3511
Provider Business Practice Location Address Fax Number:
586-757-2977
Provider Enumeration Date:
04/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
EDREA
Authorized Official Middle Name:
Authorized Official Title or Position:
PATIENT CARE
Authorized Official Telephone Number:
586-757-2806

Provider Taxonomy Codes

  • Taxonomy code: 237700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 540E00414 . This is a "BCBSM ID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0E02601 . This is a "HAP ID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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