Basic Information
Provider Information
NPI: 1881646362
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBINSON
FirstName: DIANNA
MiddleName: LYNNEE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13523 BARRETT PARKWAY DRIVE
Address2: SUITE 104
City: BALLWIN
State: MO
PostalCode: 630213802
CountryCode: US
TelephoneNumber: 6369386868
FaxNumber: 6369381486
Practice Location
Address1: 11110 MEDICAL CAMPUS RD
Address2: SUITE 200
City: HAGERSTOWN
State: MD
PostalCode: 217426700
CountryCode: US
TelephoneNumber: 3017144300
FaxNumber: 3017144324
Other Information
ProviderEnumerationDate: 05/16/2006
LastUpdateDate: 12/22/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XD59683MDY Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XD0059683MDN Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home