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NPI Code Detail

MEDICARE: DR. ROBERT C MACKOW MD

MEDICARE: DR. ROBERT C MACKOW 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
1207RN0300XNephrology Physician0101032521VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942208368
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT C MACKOW MD
Provider Business Mailing Address
First Line : 13135 LEE JACKSON MEMORIAL HWY
Second Line : 135
City : FAIRFAX
State : VA
Zip : 22033-1907
Country : US
Telephone Number : 703-961-0488
Fax Number : 703-961-0480
Provider Business Practice Location Address
First Line : 13135 LEE JACKSON MEMORIAL HWY
Second Line : 135
City : FAIRFAX
State : VA
Zip : 22033-1907
Country : US
Telephone Number : 703-961-0488
Fax Number : 703-961-0480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2005
Last Update Date : 08/11/2016

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Directions to “ DR. ROBERT C MACKOW MD” Practice Location

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