Provider Demographics
NPI:1093812562
Name:ROBINSON-REDWAY, SANDRA YVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:YVONNE
Last Name:ROBINSON-REDWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. 341
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769
Mailing Address - Country:US
Mailing Address - Phone:301-559-0151
Mailing Address - Fax:301-559-2932
Practice Address - Street 1:3331 TOLEDO TERRACE
Practice Address - Street 2:SUITE 107
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782
Practice Address - Country:US
Practice Address - Phone:301-559-0151
Practice Address - Fax:301-559-2932
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD32519207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDRO460569Medicare ID - Type Unspecified
MDE71180Medicare UPIN