Provider Demographics
NPI:1215917869
Name:MURPHY, ROBIN R (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:R
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:R
Other - Last Name:FOUNTAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M351
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-8786
Mailing Address - Fax:269-341-8984
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M351
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-8786
Practice Address - Fax:269-341-8984
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010681072080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICK6240OtherRAILROAD MEDICARE
MI4410061Medicaid
MICK6240OtherRAILROAD MEDICARE
MI0C97618054Medicare PIN