Provider Demographics
NPI:1356855910
Name:ROBINSON, MARCIA DIANA
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:DIANA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SWAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-6002
Mailing Address - Country:US
Mailing Address - Phone:301-706-3664
Mailing Address - Fax:301-292-6270
Practice Address - Street 1:800 SWAN CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-6002
Practice Address - Country:US
Practice Address - Phone:301-706-3664
Practice Address - Fax:301-292-6270
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-18
Last Update Date:2017-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker