Healthcare Provider Details

I. General information

NPI: 1962844621
Provider Name (Legal Business Name): JOHN DANIEL ROBB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON ROAD STE 1E50 CTR FOR HEART & VASCULAR HEALTH CHRISTIANA HOSPITAL
NEWARK DE
19718-2200
US

IV. Provider business mailing address

200 HYGEIA DRIVE, SUITE 2300 CCHS PHYSICIAN CONTRACTING
NEWARK DE
19713-2049
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1980
  • Fax: 302-733-1986
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberLT000728
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: