Provider Demographics
NPI:1114122017
Name:ROBBINS, CYNTHIA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LYNN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75B JOHN ROBERTS RD STE 8B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3201
Mailing Address - Country:US
Mailing Address - Phone:207-775-4151
Mailing Address - Fax:
Practice Address - Street 1:75B JOHN ROBERTS RD STE 8B
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3201
Practice Address - Country:US
Practice Address - Phone:207-775-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010683812080A0000X
MEMD271892080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201021750Medicaid
INM400060073Medicare PIN