Healthcare Provider Details

I. General information

NPI: 1194883728
Provider Name (Legal Business Name): ROBERT D KELBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14139 POTOMAC MILLS ROAD
WOODBRIDGE VA
22192
US

IV. Provider business mailing address

2101 EAST JEFFERSON STREET PPQA MEDICARE COMPLIANCE UNIT 6W ATTN THERESA BROOKS
ROCKVILLE MD
20852
US

V. Phone/Fax

Practice location:
  • Phone: 703-490-8400
  • Fax: 703-490-7635
Mailing address:
  • Phone: 301-816-6660
  • Fax: 301-816-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101222031
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101222031
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: