MEDICARE: DR. ROBERT VISSING MD

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	207R00000X	Internal Medicine Physician	D33897	MD

General Provider Information

NPI Number	:	1457352395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT VISSING MD

Provider Business Mailing Address
First Line	:	515 FAIRMOUNT AVE STE 400
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-8518
Country	:	US
Telephone Number	:	410-321-1224
Fax Number	:	410-584-1874

Provider Business Practice Location Address
First Line	:	515 FAIRMOUNT AVE STE 320
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-5466
Country	:	US
Telephone Number	:	410-321-1224
Fax Number	:	410-321-1231

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	11/30/2020

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Directions to “ DR. ROBERT VISSING MD” Practice Location

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