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General NPI Number Information
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NPI Number | 1568559029
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Entity Type | Individual
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Provider Name | ROBIN D SEBASTIAN M.D., FAAFP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 1102 E LOCUST ST
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City | EMMETT
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State | ID
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Zip | 83617-2713
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Country | US
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Telephone | 208-365-6004
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Fax | 208-365-3589
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Provider Business Mailing Address
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Address Line | 1102 E LOCUST ST
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City | EMMETT
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State | ID
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Zip | 83617-2713
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Country | US
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Telephone | 208-365-6004
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Fax | 208-365-3589
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD435743
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT188205
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M10681
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License Number State | ID
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