MEDICARE: DR. ROBIN L PLANK D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS010842L	PA

General Provider Information

NPI Number	:	1174503437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN L PLANK D.O.

Provider Business Mailing Address
First Line	:	100 INNOVATION DRIVE
Second Line	:	SUITE 101
City	:	SLIPPERY ROCK
State	:	PA
Zip	:	16057-0000
Country	:	US
Telephone Number	:	724-794-4023
Fax Number	:	724-794-3675

Provider Business Practice Location Address
First Line	:	100 INNOVATION DRIVE
Second Line	:	SUITE 101
City	:	SLIPPERY ROCK
State	:	PA
Zip	:	16057-0000
Country	:	US
Telephone Number	:	724-794-4023
Fax Number	:	724-794-3675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	04/08/2011

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