Healthcare Provider Details

I. General information

NPI: 1669443446
Provider Name (Legal Business Name): ROBERT ISAACS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20410 OBSERVATION DR SUITE 104
GERMANTOWN MD
20876-4000
US

IV. Provider business mailing address

20410 OBSERVATION DR SUITE 104
GERMANTOWN MD
20876-4000
US

V. Phone/Fax

Practice location:
  • Phone: 301-948-5700
  • Fax: 301-212-4277
Mailing address:
  • Phone: 301-948-5700
  • Fax: 301-212-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD38257
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: