Provider Demographics
NPI:1083742621
Name:DONALD, ROBIN L (DO)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:DONALD
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:6020 RICHMOND HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-2157
Mailing Address - Country:US
Mailing Address - Phone:443-393-3653
Mailing Address - Fax:
Practice Address - Street 1:1141 ELDEN ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5549
Practice Address - Country:US
Practice Address - Phone:703-481-8160
Practice Address - Fax:703-435-6752
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2022-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102202462207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1083742621Medicaid
VA021349N42Medicare PIN