Healthcare Provider Details

I. General information

NPI: 1851360226
Provider Name (Legal Business Name): ROBERT MICHAEL HINES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 5TH ST NE SUITE 15
BARBERTON OH
44203-3017
US

IV. Provider business mailing address

95 ARCH ST SUITE 210
AKRON OH
44304-1437
US

V. Phone/Fax

Practice location:
  • Phone: 330-753-6161
  • Fax: 330-753-5508
Mailing address:
  • Phone: 330-253-1411
  • Fax: 330-253-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35049487
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35-049487
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: