Healthcare Provider Details

I. General information

NPI: 1528054400
Provider Name (Legal Business Name): ROBINSON U ORDONA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 W 13 MILE RD STE 702A
ROYAL OAK MI
48073-6710
US

IV. Provider business mailing address

3535 W 13 MILE RD STE 702A
ROYAL OAK MI
48073-6710
US

V. Phone/Fax

Practice location:
  • Phone: 248-288-2114
  • Fax: 248-551-6170
Mailing address:
  • Phone: 248-288-2114
  • Fax: 248-551-6170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number4301031349
License Number StateMI

VIII. Authorized Official

Name: ROBINSON U ORDONA
Title or Position: PRESIDENT
Credential: MD PC
Phone: 248-288-2114