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General NPI Number Information
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NPI Number | 1598041477
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Entity Type | Organization
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Legal Business Name | ROBERT A. NUSSBAUM, MD, P.C.
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 6355 WALKER LN STE 309
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City | ALEXANDRIA
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State | VA
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Zip | 22310-3247
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Country | US
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Telephone | 703-313-8400
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Fax | 703-313-9666
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Provider Business Mailing Address
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Address Line | 6355 WALKER LN STE 309
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City | ALEXANDRIA
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State | VA
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Zip | 22310-3247
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Country | US
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Telephone | 703-313-8400
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Fax | 703-313-9666
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT A NUSSBAUM
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Credential | M.D.
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Telephone | 703-313-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0101047887
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License Number State | VA
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