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NPI Code Detail

MEDICARE: ROBERT W WOODSIDE MPT DPT

MEDICARE: ROBERT W WOODSIDE MPT DPT
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
1225100000XPhysical Therapist20287MD

General Provider Information

NPI Number : 1619901741
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT W WOODSIDE MPT DPT
Provider Business Mailing Address
First Line : 850 HUNGERFORD DR
Second Line :
City : ROCKVILLE
State : MD
Zip : 20850-1718
Country : US
Telephone Number : 240-740-5500
Fax Number :
Provider Business Practice Location Address
First Line : MCPS PHYSICAL DISABILITIES PROGRAM
Second Line : 8001 LYNNBROOK DRIVE
City : BETHESDA
State : MD
Zip : 20814-4642
Country : US
Telephone Number : 240-740-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 03/07/2019

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