MEDICARE: MR. ROBERT MASSEY

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	1835N0905X	Nuclear Pharmacist	13006	LA

General Provider Information

NPI Number	:	1982796652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT MASSEY

Provider Business Mailing Address
First Line	:	10034 BLUE BANNER DR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-4446
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	WALTER REED ARMY MEDICAL CTR
Second Line	:	6900 GEORGIA AVENUE NW
City	:	WASHINGTON
State	:	DC
Zip	:	20307-0001
Country	:	US
Telephone Number	:	202-782-0169
Fax Number	:

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/08/2007

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