Basic Information
| Provider Information | |||||||||
| NPI: | 1699748483 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | HENRY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2024 GEORGIA AVENUE, NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028654403 | ||||||||
| FaxNumber: | 2028653212 | ||||||||
| Practice Location | |||||||||
| Address1: | 2041 GEORGIA AVENUE, NW | ||||||||
| Address2: | SUITE 3200 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028654403 | ||||||||
| FaxNumber: | 2028653214 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2006 | ||||||||
| LastUpdateDate: | 12/01/2010 | ||||||||
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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 | 207QG0300X | MD3766 | DC | Y | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 011707100 | 05 | DC | MEDICAID | 9694 | 01 | DC | CAREFIRST BCBS | OTHER |