Healthcare Provider Details

I. General information

NPI: 1265528624
Provider Name (Legal Business Name): MAX H ROBINS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7086 WINDING BROOK CT
W BLOOMFIELD MI
48322-3584
US

IV. Provider business mailing address

7086 WINDING BROOK CT
W BLOOMFIELD MI
48322-3584
US

V. Phone/Fax

Practice location:
  • Phone: 248-432-7192
  • Fax:
Mailing address:
  • Phone: 248-432-7192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number5101005496
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: