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NPI Code Detail

MEDICARE: DR. ROBERT WILLIAM DESVERREAUX M.D.,PH.D.

MEDICARE: DR. ROBERT WILLIAM DESVERREAUX M.D.,PH.D.
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
1207P00000XEmergency Medicine PhysicianD0047028MD

General Provider Information

NPI Number : 1851391296
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT WILLIAM DESVERREAUX M.D.,PH.D.
Provider Business Mailing Address
First Line : PO BOX 759047
Second Line :
City : BALTIMORE
State : MD
Zip : 21275-9047
Country : US
Telephone Number : 804-968-5700
Fax Number :
Provider Business Practice Location Address
First Line : 2051 WEST ST
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-3006
Country : US
Telephone Number : 443-603-0758
Fax Number : 443-603-0759
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 10/19/2016

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