Healthcare Provider Details

I. General information

NPI: 1043206295
Provider Name (Legal Business Name): ROBIN D KOLLMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 OXFORD ST STE 220
DOVER OH
44622
US

IV. Provider business mailing address

819 N 1ST ST
DENNISON OH
44621-1003
US

V. Phone/Fax

Practice location:
  • Phone: 330-666-3400
  • Fax:
Mailing address:
  • Phone: 740-922-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35048322
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: