Healthcare Provider Details

I. General information

NPI: 1366745101
Provider Name (Legal Business Name): MARCUS D. ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2010
Last Update Date: 12/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 PUBLIC LANDING RD
SNOW HILL MD
21863-2453
US

IV. Provider business mailing address

6040 PUBLIC LANDING RD
SNOW HILL MD
21863-2453
US

V. Phone/Fax

Practice location:
  • Phone: 410-632-1100
  • Fax: 410-632-5682
Mailing address:
  • Phone: 410-632-1100
  • Fax: 410-632-5682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: