Healthcare Provider Details

I. General information

NPI: 1043499312
Provider Name (Legal Business Name): ROBERT J KREITMAN MP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18111 PRINCE PHILIP DR #327
OLNEY MD
20832
US

IV. Provider business mailing address

18111 PRINCE PHILIP DR #327 MILLER KAPLAN & RAJAGOPAL PC
OLNEY MD
20832
US

V. Phone/Fax

Practice location:
  • Phone: 301-774-6136
  • Fax: 301-570-0136
Mailing address:
  • Phone: 301-774-6136
  • Fax: 301-570-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD0037888
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: