Provider Demographics
NPI:1508943291
Name:ROBERTSON, DONA H (CNM)
Entity Type:Individual
Prefix:
First Name:DONA
Middle Name:H
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:DONA
Other - Middle Name:M
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P O BOX 420
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078
Mailing Address - Country:US
Mailing Address - Phone:410-939-3121
Mailing Address - Fax:410-939-8278
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 301
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:443-643-4300
Practice Address - Fax:443-643-4303
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR139296367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
89286401OtherBCBS
0001OtherBCBS
315096OtherAMERIGROUP
MD411678000Medicaid
612176400OtherFEDERAL WORKMANS COMP
1441858OtherAETNA
129NQ029Medicare PIN