Individual
ROBERT C MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3619 PARK EAST DR, SUITE 313, BEACHWOOD, OH 44122-4330
(216) 591-0500
(216) 591-0550
Mailing address
3619 PARK EAST DR, SUITE 313, BEACHWOOD, OH 44122-4330
(216) 591-0500
(216) 591-0550
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4826
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000137850
ANTHEM
OH
05
—
0986081
—
OH
01
—
P00127008
RAILROAD MEDICARE
OH
Enumeration date
10/18/2006
Last updated
03/24/2008
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