Healthcare Provider Details

I. General information

NPI: 1447222088
Provider Name (Legal Business Name): MAVA BRIANA ROBINSON-WALTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANA WALTON MD

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 GEORGIA AVE STE 205
SILVER SPRING MD
20902-5020
US

IV. Provider business mailing address

8110 MAPLE LAWN BLVD STE 235
FULTON MD
20759-2694
US

V. Phone/Fax

Practice location:
  • Phone: 301-592-1600
  • Fax: 301-592-1602
Mailing address:
  • Phone: 301-340-8339
  • Fax: 301-340-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0060942
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD33866
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberD60942
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: