Healthcare Provider Details

I. General information

NPI: 1427095793
Provider Name (Legal Business Name): ROBIN GUGENHEIM WITKIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 09/11/2025
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 PROSPERITY DR STE 100
SILVER SPRING MD
20904-1647
US

IV. Provider business mailing address

12501 PROSPERITY DR STE 100
SILVER SPRING MD
20904-1647
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-6730
  • Fax: 301-681-4268
Mailing address:
  • Phone: 301-681-6730
  • Fax: 301-681-4268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberD0044766
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: