Provider Demographics
NPI:1629040001
Name:SILEO, ROBERT P (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:SILEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PARK ST SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4644
Mailing Address - Country:US
Mailing Address - Phone:703-938-7100
Mailing Address - Fax:703-938-1261
Practice Address - Street 1:201 PARK ST SE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4644
Practice Address - Country:US
Practice Address - Phone:703-938-7100
Practice Address - Fax:703-938-1261
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA110032871Medicare PIN
VA126837Medicare PIN
VAC87822Medicare UPIN