Basic Information
Provider Information
NPI: 1174535454
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HELMLY
FirstName: ROBERT
MiddleName: BRUCE
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 920 ELKRIDGE LANDING RD
Address2:  
City: LINTHICUM
State: MD
PostalCode: 210902917
CountryCode: US
TelephoneNumber: 4434625010
FaxNumber:  
Practice Location
Address1: 500 CADMUS LN STE 207
Address2:  
City: EASTON
State: MD
PostalCode: 21601
CountryCode: US
TelephoneNumber: 4108225571
FaxNumber: 4108223859
Other Information
ProviderEnumerationDate: 08/13/2006
LastUpdateDate: 08/12/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XD53236MDY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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