Provider Demographics
NPI:1407274871
Name:PRZYBYLSKI, ROBERT
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:PRZYBYLSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 NORTHWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-3921
Mailing Address - Country:US
Mailing Address - Phone:248-217-9186
Mailing Address - Fax:
Practice Address - Street 1:8260 WILLOW OAKS CORPORATE DR STE 400
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4513
Practice Address - Country:US
Practice Address - Phone:571-472-4600
Practice Address - Fax:703-573-4856
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012778612080P0202X
MA270309208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics