MEDICARE: ROBERT G STENBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD042175L	PA
2	207RC0000X	Cardiovascular Disease Physician	MD042175L	PA
3	207RI0011X	Interventional Cardiology Physician	MD042175L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164453841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT G STENBERG MD

Provider Business Mailing Address
First Line	:	8100 ASHTON AVE STE 200
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20109-5688
Country	:	US
Telephone Number	:	877-415-4116
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 ASHTON AVE STE 200
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20109-5688
Country	:	US
Telephone Number	:	877-415-4116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	11/08/2021

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