Healthcare Provider Details

I. General information

NPI: 1801462478
Provider Name (Legal Business Name): CIJI CHRISTINA ROBINSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 NORTH EAST AVENUE
JACKSON MI
49201
US

IV. Provider business mailing address

205 NORTH EAST AVENUE
JACKSON MI
49201
US

V. Phone/Fax

Practice location:
  • Phone: 517-205-1731
  • Fax:
Mailing address:
  • Phone: 517-205-1731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351047647
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: