Provider Demographics
NPI:1316215122
Name:GILBERT, ROBERTA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:M
Last Name:GILBERT
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 1:136 RUFFED GROUSE CT.
Mailing Address - Street 2:
Mailing Address - City:LAKE FREDERICK
Mailing Address - State:VA
Mailing Address - Zip Code:22630
Mailing Address - Country:US
Mailing Address - Phone:540-868-0866
Mailing Address - Fax:
Practice Address - Street 1:136 RUFFED GROUSE CT.
Practice Address - Street 2:
Practice Address - City:LAKE FREDERICK
Practice Address - State:VA
Practice Address - Zip Code:22630
Practice Address - Country:US
Practice Address - Phone:540-868-0866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010412772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry