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Individual

CHARIECE LASALLE ROBINSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
503 N MAPLE ST, EFFINGHAM, IL 62401-2006
(217) 347-6127
(217) 347-1538
Mailing address
503 N MAPLE ST, EFFINGHAM, IL 62401-2006
(217) 347-6127
(217) 347-1538

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.089972
IL
208M00000X
Hospitalist Physician
Primary
036.089972
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000530518
ANTHEM, BCBS
IN
05
200879660
IN
01
M47140099
IN MEDICARE NUMBER
IN
Enumeration date
03/12/2007
Last updated
12/28/2016
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