MEDICARE: ROBERT MAMAN 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	2084P0800X	Psychiatry Physician	0101037172	VA
2	2084P0800X	Psychiatry Physician	D0032839	MD

General Provider Information

NPI Number	:	1659368538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MAMAN MD

Provider Business Mailing Address
First Line	:	12301 SAINT JAMES RD
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-2168
Country	:	US
Telephone Number	:	240-535-9409
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 WASHINGTON BLVD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5703
Country	:	US
Telephone Number	:	703-228-5150
Fax Number	:	703-228-5157

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	09/10/2024

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