Healthcare Provider Details

I. General information

NPI: 1942274998
Provider Name (Legal Business Name): ROBERT S CLEVELAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 WESTSIDE DR
DOTHAN AL
36303-1928
US

IV. Provider business mailing address

202 WESTSIDE DR
DOTHAN AL
36303-1928
US

V. Phone/Fax

Practice location:
  • Phone: 334-699-2229
  • Fax: 334-699-4084
Mailing address:
  • Phone: 334-699-2229
  • Fax: 334-699-4084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number00016446
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier51003136
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBXBS
# 2
Identifier203929220
Identifier TypeOTHER
Identifier State
Identifier IssuerTRICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: