Provider Demographics
NPI:1447222088
Name:ROBINSON-WALTON, MAVA BRIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAVA
Middle Name:BRIANA
Last Name:ROBINSON-WALTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:
Other - Last Name:WALTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8110 MAPLE LAWN BLVD
Mailing Address - Street 2:STE 235
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:10301 GEORGIA AVE STE 205
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5020
Practice Address - Country:US
Practice Address - Phone:301-592-1600
Practice Address - Fax:301-592-1602
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060942207V00000X
DCMD33866207V00000X
MDD60942207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC511206100Medicaid
7984083OtherAETNA PPO
93604502OtherBCBS MD
MDD60942OtherSTATE LICENSE
1782731OtherAETNA HMO
DC006205551Medicaid
DC034192800Medicaid
DCX3640002OtherBCBS
MD511206101Medicaid
MD93604504OtherBCBS
N4350001OtherBCBS DC
MD010216249Medicaid
93604503OtherBCBS MARYLAND
DCG99740Medicare UPIN
MD129NT019Medicare PIN
MD010216249Medicaid
93604503OtherBCBS MARYLAND
DC511206100Medicaid
MDP00975122Medicare PIN