Healthcare Provider Details

I. General information

NPI: 1629098579
Provider Name (Legal Business Name): DAVID ALAN ROBINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10110 DONALD S POWERS DRIVE SUITE 201A
MUNSTER IN
46321
US

IV. Provider business mailing address

10110 DONALD S POWERS DRIVE SUITE 201A
MUNSTER IN
46321
US

V. Phone/Fax

Practice location:
  • Phone: 219-513-2100
  • Fax: 219-836-2100
Mailing address:
  • Phone: 219-513-2100
  • Fax: 219-836-2100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number01053821A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: