Healthcare Provider Details

I. General information

NPI: 1770664765
Provider Name (Legal Business Name): BRIAN DAVID ROBERTSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE. WALTER REED NMMC, DEPT OF MEDICINE/SLEEP MEDICINE
BETHESDA MD
20878
US

IV. Provider business mailing address

563 CHESTERTOWN ST
GAITHERSBURG MD
20878-5717
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4547
  • Fax:
Mailing address:
  • Phone: 706-888-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberD0083156
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0083156
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD0083156
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: