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NPI Code Detail

MEDICARE: GREGORY ROBINSON PHD

MEDICARE: GREGORY ROBINSON PHD
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
1103TC0700XClinical Psychologist0810-000351VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770562019
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY ROBINSON PHD
Provider Business Mailing Address
First Line : 1030 S JEFFERSON ST
Second Line :
City : ROANOKE
State : VA
Zip : 24016-4418
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4348 ELECTRIC RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-0720
Country : US
Telephone Number : 407-690-9765
Fax Number : 540-857-5386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2006
Last Update Date : 11/05/2021

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