Healthcare Provider Details

I. General information

NPI: 1861436156
Provider Name (Legal Business Name): ROBERT F CORDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 DEFENSE HWY STE 101
ANNAPOLIS MD
21401-8921
US

IV. Provider business mailing address

PO BOX 597
OAKLAND MD
21550-4597
US

V. Phone/Fax

Practice location:
  • Phone: 410-834-1069
  • Fax: 410-224-3370
Mailing address:
  • Phone: 301-533-4000
  • Fax: 301-533-4208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0054861
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: