MEDICARE: DR. KESHA SHUNTE ROBERTSON M.D.

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	207V00000X	Obstetrics & Gynecology Physician	57684	TN
2	207V00000X	Obstetrics & Gynecology Physician	0101279656	VA
3	208M00000X	Hospitalist Physician	0101279656	VA
4	207V00000X	Obstetrics & Gynecology Physician	D85185	MD
5	208M00000X	Hospitalist Physician	57684	TN
6	207V00000X	Obstetrics & Gynecology Physician	N4041	TX

General Provider Information

NPI Number	:	1790932499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KESHA SHUNTE ROBERTSON M.D.

Provider Business Mailing Address
First Line	:	100 HOSPITAL ROAD
Second Line	:	ATTN: CONTRACTING & CREDENTIALING COORDINATOR
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678
Country	:	US
Telephone Number	:	410-414-4791
Fax Number	:	410-414-2721

Provider Business Practice Location Address
First Line	:	110 HOSPITAL RD STE 203
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-4045
Country	:	US
Telephone Number	:	410-414-4740
Fax Number	:	410-414-4741

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

Provider Enumeration Date	:	08/25/2008
Last Update Date	:	09/05/2025

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Directions to “ DR. KESHA SHUNTE ROBERTSON M.D.” Practice Location

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