Healthcare Provider Details

I. General information

NPI: 1821203803
Provider Name (Legal Business Name): EDWEANA M ROBINSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 EUCLID AVE
CLEVELAND OH
44106-1712
US

IV. Provider business mailing address

2403 TRAYMORE RD
UNIVERSITY HEIGHTS OH
44118-3750
US

V. Phone/Fax

Practice location:
  • Phone: 215-368-2450
  • Fax:
Mailing address:
  • Phone: 216-321-3513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35-046633
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: