Provider Demographics
NPI:1194033779
Name:ROBILOTTO, PHILIP JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:JOSEPH
Last Name:ROBILOTTO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8603 AUGUSTA FARM LN
Mailing Address - Street 2:
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-1423
Mailing Address - Country:US
Mailing Address - Phone:301-253-3668
Mailing Address - Fax:
Practice Address - Street 1:7-1 METROPOLITAN COURT
Practice Address - Street 2:MERCY HEALTH CLINIC
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20885-4115
Practice Address - Country:US
Practice Address - Phone:240-773-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0059690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF71767Medicare UPIN