Basic Information
Provider Information | |||||||||
NPI: | 1730182775 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | NEE | ||||||||
FirstName: | ROBERT | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 8901 ROCKVILLE PIKE | ||||||||
Address2: |   | ||||||||
City: | BETHESDA | ||||||||
State: | MD | ||||||||
PostalCode: | 20889 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3012954331 | ||||||||
FaxNumber: | 3012956081 | ||||||||
Practice Location | |||||||||
Address1: | 8901 ROCKVILLE PIKE | ||||||||
Address2: |   | ||||||||
City: | BETHESDA | ||||||||
State: | MD | ||||||||
PostalCode: | 208893026 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3012954331 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/23/2005 | ||||||||
LastUpdateDate: | 03/08/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 0101234840 | VA | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
ID | Type | State | Issuer | Description | 437672 | 01 | VA | ANTHEM WARRENTON | OTHER | 0007831475 | 01 | VA | AETNA | OTHER | 010006261 | 05 | VA |   | MEDICAID | 437671 | 01 | VA | ANTHEM CULPEPER | OTHER | 2096610 | 01 | VA | FIRSTHEALTH | OTHER | 8539447001 | 01 | VA | CIGNA | OTHER | 2110952 | 01 | VA | MAMSI | OTHER | 64637 | 01 | VA | UNICARE | OTHER | 69759 | 01 | VA | SENTARA | OTHER | 41950006 | 01 | VA | CAREFIRST | OTHER | 010006261 | 01 | VA | VIRGINIA PREMIER HEALTH | OTHER | 213131 | 01 | VA | SOUTHERN HEALTH | OTHER |