MEDICARE: MR. CORNELIUS ROBENS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	4301081829	MI
2	2084N0400X	Neurology Physician	4301081829	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538158688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CORNELIUS ROBENS M.D.

Provider Business Mailing Address
First Line	:	4100 PARK FOREST DR STE 200
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7306
Country	:	US
Telephone Number	:	231-600-7466
Fax Number	:	877-370-4631

Provider Business Practice Location Address
First Line	:	4100 PARK FOREST DR STE 200
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7306
Country	:	US
Telephone Number	:	231-600-7466
Fax Number	:	877-370-4631

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/01/2025

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