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General NPI Number Information
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NPI Number | 1750558045
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Entity Type | Individual
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Provider Name | RICHARD B ROTHMAN M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 3923 OLD LEE HWY SUITE 61A
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City | FAIRFAX
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State | VA
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Zip | 22030-2428
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Country | US
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Telephone | 703-359-9200
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Fax | 866-467-9404
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Provider Business Mailing Address
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Address Line | 12719 FOLLY QUARTER RD
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-1275
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Country | US
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Telephone | 703-359-9200
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Fax | 866-467-9404
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0002X
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Taxonomy Name | Obesity Medicine (Psychiatry & Neurology) Physician
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License Number | D34382
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2084B0002X
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Taxonomy Name | Obesity Medicine (Psychiatry & Neurology) Physician
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License Number | 0101040220
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101040220
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D34382
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License Number State | MD
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