Healthcare Provider Details

I. General information

NPI: 1265432850
Provider Name (Legal Business Name): ROBIN G STANKO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 S CLEVELAND AVE SUITE B
WESTERVILLE OH
43081-8959
US

IV. Provider business mailing address

568 S CLEVELAND AVE SUITE B
WESTERVILLE OH
43081-8959
US

V. Phone/Fax

Practice location:
  • Phone: 614-895-3344
  • Fax: 614-895-3795
Mailing address:
  • Phone: 614-895-3344
  • Fax: 614-895-3795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35046236
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: