1528054400 NPI number — ROBINSON U ORDONA MD PC

Table of content: (NPI 1528054400)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528054400 NPI number — ROBINSON U ORDONA MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBINSON U ORDONA MD PC
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:
1528054400
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:
3535 W 13 MILE RD
Provider Second Line Business Mailing Address:
STE 702A
Provider Business Mailing Address City Name:
ROYAL OAK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48073-6710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-288-2114
Provider Business Mailing Address Fax Number:
248-551-6170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3535 W 13 MILE RD
Provider Second Line Business Practice Location Address:
STE 702A
Provider Business Practice Location Address City Name:
ROYAL OAK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48073-6710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-288-2114
Provider Business Practice Location Address Fax Number:
248-551-6170
Provider Enumeration Date:
09/26/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ORDONA
Authorized Official First Name:
ROBINSON
Authorized Official Middle Name:
U
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-288-2114

Provider Taxonomy Codes

  • Taxonomy code: 2086S0122X , with the licence number:  4301031349 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1236860002 . This is a "WELLNESS PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 134678 . This is a "GREAT LAKES HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000002262 . This is a "CAPE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 011851 . This is a "MIDWEST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2406312502 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1066526 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".