Healthcare Provider Details

I. General information

NPI: 1104896323
Provider Name (Legal Business Name): CAROLYN O ROBINSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 08/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13450 N MERIDIAN ST
CARMEL IN
46032-1546
US

IV. Provider business mailing address

13450 N MERIDIAN STREET #260
CARMEL IN
46032
US

V. Phone/Fax

Practice location:
  • Phone: 317-582-7360
  • Fax: 317-582-7413
Mailing address:
  • Phone: 317-582-7360
  • Fax: 317-582-7413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number01036100A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number01036100A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: