Provider Demographics
NPI:1730427659
Name:ROBINSON, JOHN P (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
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 1:221 MICHIGAN ST NE STE 300
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2537
Mailing Address - Country:US
Mailing Address - Phone:616-459-7258
Mailing Address - Fax:616-459-5215
Practice Address - Street 1:3601 WEST 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-898-2673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2025-04-18
Deactivation Date:2018-06-07
Deactivation Code:
Reactivation Date:2018-06-16
Provider Licenses
StateLicense IDTaxonomies
MI4301115694208600000X
363A00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant