Provider Demographics
NPI:1992785448
Name:GISH, ROBIN D (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:GISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:418 CLOVERLEAF RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-9320
Mailing Address - Country:US
Mailing Address - Phone:717-653-1467
Mailing Address - Fax:717-653-1001
Practice Address - Street 1:418 CLOVERLEAF RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-9320
Practice Address - Country:US
Practice Address - Phone:717-653-1467
Practice Address - Fax:717-653-1001
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD039431E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE27371OtherHEALTH ASSURANCE
PA0011781480001Medicaid
PA573854OtherHIGHMARK BLUE SHIELD
PA01936801OtherCAPITAL BLUE CROSS
PA24453 S101OtherGEISINGER HEALTH PLAN
PAP002714OtherGATEWAY HEALTH PLAN
PAP002714OtherGATEWAY HEALTH PLAN
PA01936801OtherCAPITAL BLUE CROSS