Basic Information
| Provider Information | |||||||||
| NPI: | 1679971063 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAMESON | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MS OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 POST OFFICE RD | ||||||||
| Address2: | SUITE NUMBER 105 | ||||||||
| City: | WALDORF | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206022756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018932345 | ||||||||
| FaxNumber: | 3016381783 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 POST OFFICE RD | ||||||||
| Address2: | SUITE NUMBER 105 | ||||||||
| City: | WALDORF | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206022756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018932345 | ||||||||
| FaxNumber: | 3016381783 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2014 | ||||||||
| LastUpdateDate: | 12/17/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 07488 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.