Healthcare Provider Details

I. General information

NPI: 1548237811
Provider Name (Legal Business Name): ROBERT JOHN PIERCE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

7901 HENRY AVE #E310
PHILADELPHIA PA
19128-3060
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-0974
  • Fax:
Mailing address:
  • Phone: 215-509-6499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC003557R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: