Provider Demographics
NPI:1245212554
Name:KALIL, ROBERTO S (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:S
Last Name:KALIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-328-8040
Mailing Address - Fax:443-462-3514
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-384-7998
Practice Address - Fax:319-384-8220
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA33599207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0218883Medicaid
IA22858OtherWELLMARK BCBS
IA0218883Medicaid
IA22858OtherWELLMARK BCBS