Healthcare Provider Details

I. General information

NPI: 1306924469
Provider Name (Legal Business Name): ROBERT WAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE NATIONAL NAVAL MEDICAL CENTER
BETHESDA MD
20814
US

IV. Provider business mailing address

515 N STATE ST ATTN PEGGY DUHIG
CHICAGO IL
60610-5453
US

V. Phone/Fax

Practice location:
  • Phone: 202-340-3811
  • Fax:
Mailing address:
  • Phone: 202-340-3811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number01051729A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: