Basic Information
Provider Information | |||||||||
NPI: | 1649561176 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ROBLES | ||||||||
FirstName: | ERIN | ||||||||
MiddleName: | ROBYN | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | D.P.M. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1600 E GUDE DR | ||||||||
Address2: | SUITE 200 | ||||||||
City: | ROCKVILLE | ||||||||
State: | MD | ||||||||
PostalCode: | 208501341 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3019337133 | ||||||||
FaxNumber: | 3019337137 | ||||||||
Practice Location | |||||||||
Address1: | 2021 K ST NW | ||||||||
Address2: | SUITE 520 | ||||||||
City: | WASHINGTON | ||||||||
State: | DC | ||||||||
PostalCode: | 200061003 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2022234616 | ||||||||
FaxNumber: | 2022230740 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/02/2011 | ||||||||
LastUpdateDate: | 12/11/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 01558 | MD | Y |   | Podiatric Medicine & Surgery Service Providers | Podiatrist |   | 213E00000X | P01000105 | DC | N |   | Podiatric Medicine & Surgery Service Providers | Podiatrist |   |
ID Information
ID | Type | State | Issuer | Description | 361352YFCT | 01 | DC | DC MEDICARE | OTHER | 079194600 | 01 | MD | MD MEDICAID | OTHER |