Healthcare Provider Details

I. General information

NPI: 1295600351
Provider Name (Legal Business Name): MARYLAND ONCOLOGY HEMATOLOGY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 WISCONSIN AVE STE 1640
CHEVY CHASE MD
20815-4305
US

IV. Provider business mailing address

11720 BELTSVILLE DR STE 300
BELTSVILLE MD
20705-3119
US

V. Phone/Fax

Practice location:
  • Phone: 301-657-4588
  • Fax: 301-657-9565
Mailing address:
  • Phone: 240-223-1893
  • Fax: 301-326-2926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT DAVIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 202-909-3301