Healthcare Provider Details
I. General information
NPI: 1821912262
Provider Name (Legal Business Name): MIDATLANTIC ENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5454 WISCONSIN AVE STE 1535
CHEVY CHASE MD
20815-6922
US
IV. Provider business mailing address
5454 WISCONSIN AVE STE 1535
CHEVY CHASE MD
20815-6922
US
V. Phone/Fax
- Phone: 301-657-7850
- Fax:
- Phone: 301-657-7850
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207YX0007X |
| Taxonomy | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
SCOTT
ROBINSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 301-550-1825