Provider Demographics
NPI:1487806311
Name:ROBB, ANN THERESE (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:THERESE
Last Name:ROBB
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 1:2915 E BASELINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2427
Mailing Address - Country:US
Mailing Address - Phone:480-776-0626
Mailing Address - Fax:480-776-0627
Practice Address - Street 1:7721 E WOLF CANYON ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-0980
Practice Address - Country:US
Practice Address - Phone:480-242-8102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12842171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ830429940OtherTAX ID NUMBER