Provider Demographics
NPI:1508170465
Name:ROBERT D CENDO M D P A
Entity Type:Organization
Organization Name:ROBERT D CENDO M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DAMEAN
Authorized Official - Last Name:CENDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-777-7470
Mailing Address - Street 1:940 SETON DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1818
Mailing Address - Country:US
Mailing Address - Phone:301-777-7470
Mailing Address - Fax:301-724-3919
Practice Address - Street 1:940 SETON DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1818
Practice Address - Country:US
Practice Address - Phone:301-777-7470
Practice Address - Fax:301-724-3919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD37970207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD527291200Medicaid
MD527291200Medicaid
MD2135Medicare PIN