Healthcare Provider Details

I. General information

NPI: 1265442206
Provider Name (Legal Business Name): MARK S ROBBINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARK STANTON ROBBINS MD

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 PONTIAC AVE SUITE 101
CRANSTON RI
02920
US

IV. Provider business mailing address

455 TOLL GATE RD PRC AND CREDENTIALING
WARWICK RI
02886-2759
US

V. Phone/Fax

Practice location:
  • Phone: 401-943-4660
  • Fax:
Mailing address:
  • Phone: 401-273-0641
  • Fax: 401-273-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD20594
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: