Provider Demographics
NPI:1699760215
Name:ROBINSON, KEVIN BARTEL (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:BARTEL
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5889 BAY RD
Mailing Address - Street 2:STE 105
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2539
Mailing Address - Country:US
Mailing Address - Phone:989-790-3669
Mailing Address - Fax:989-790-4945
Practice Address - Street 1:5889 BAY RD
Practice Address - Street 2:SUITE 105
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2540
Practice Address - Country:US
Practice Address - Phone:989-790-3669
Practice Address - Fax:989-790-4945
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKR064676207X00000X
MI4301064676207X00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00036190OtherMEDICARE RAILROAD
MI200732116OtherBLUE CROSS BLUE SHIELD
MI2K07321162OtherHEALTH PLUS
MI4090580 10Medicaid