Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35-095435 | OH |
Y | 2080P0216X | Pediatric Rheumatologist | 35.095435 | OH |
NPI | 1013134857 |
---|---|
Provider Name | Angela Byun Robinson |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 12/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1026872770001 | (05) | PA |
3071965 | (05) | OH |