Healthcare Provider Details

I. General information

NPI: 1730157371
Provider Name (Legal Business Name): ROBERT L MARSH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 LAKE MANASSAS DR
GAINESVILLE VA
20155-3257
US

IV. Provider business mailing address

3040 WILLIAMS DR STE 100
FAIRFAX VA
22031-4618
US

V. Phone/Fax

Practice location:
  • Phone: 571-222-2200
  • Fax: 571-222-2202
Mailing address:
  • Phone: 571-350-8400
  • Fax: 703-940-8697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number0101230234
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: