Provider Demographics
NPI:1215907159
Name:ROBINSON, DONALD
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 5TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1641
Mailing Address - Country:US
Mailing Address - Phone:810-406-4246
Mailing Address - Fax:810-424-6029
Practice Address - Street 1:5710 CLIO RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-1524
Practice Address - Country:US
Practice Address - Phone:810-787-4445
Practice Address - Fax:810-787-4491
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059390207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4798100Medicaid
MI0B56065016Medicare PIN
MIG92244Medicare UPIN