Provider Demographics
NPI:1265635858
Name:HAGAN, ROBERT STEWART (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEWART
Last Name:HAGAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 HOPKINS BAYVIEW CIR
Mailing Address - Street 2:PULMONARY CLINIC, 2ND FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-6821
Mailing Address - Country:US
Mailing Address - Phone:410-550-2304
Mailing Address - Fax:410-550-8050
Practice Address - Street 1:JOHNS HOPKINS MEDICINE
Practice Address - Street 2:600 N. WOLFE ST.
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-955-7963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22260207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD22190OtherMSO DATABASE NUMBER