MEDICARE: ROBERT SURE LANDER SR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		DC

General Provider Information

NPI Number	:	1003780214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT SURE LANDER SR.

Provider Business Mailing Address
First Line	:	5407 NEWBY AVE
Second Line	:
City	:	RIVERDALE
State	:	MD
Zip	:	20737-3036
Country	:	US
Telephone Number	:	240-467-6363
Fax Number	:

Provider Business Practice Location Address
First Line	:	4737 QUEENS CHAPEL TER NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-3138
Country	:	US
Telephone Number	:	240-467-6363
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	10/08/2025

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