Provider Demographics
NPI:1568469286
Name:STEPHENS, ROBERT FREDERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FREDERIC
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6410 ROCKLEDGE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1842
Mailing Address - Country:US
Mailing Address - Phone:301-530-5200
Mailing Address - Fax:301-493-6577
Practice Address - Street 1:6720A ROCKLEDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1888
Practice Address - Country:US
Practice Address - Phone:301-530-5200
Practice Address - Fax:301-493-6577
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0024928207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD176361Medicare ID - Type UnspecifiedGROUP
MDC62491Medicare UPIN
MD400222R61Medicare ID - Type UnspecifiedPHYSICIAN AND SURGEON