Provider Demographics
NPI:1790753325
Name:REID, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:REID
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3040 WILLIAMS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4618
Mailing Address - Country:US
Mailing Address - Phone:571-350-8400
Mailing Address - Fax:703-940-8697
Practice Address - Street 1:8613 LEE HWY # 200N
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2171
Practice Address - Country:US
Practice Address - Phone:703-208-3155
Practice Address - Fax:703-280-9596
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-10-24
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Provider Licenses
StateLicense IDTaxonomies
VA0101053857207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA504740OtherNCPPO
VA541795091OtherPHCS PPO/POS
VA0870-010OtherBCBS NCA - CARE FIRST
VA500617-824248OtherAETNA HMO
VA3600353OtherUNITED HEALTHCARE
VA316256-244725OtherMAMSI/OP CHOICE/ALLIANCE
VA223807OtherKAISER
VA284759OtherTRIGON/ANTHEM
VA4545490004OtherCIGNA POS/PPO
VA541795091OtherTRICARE
VA541795091OtherFX CTY COMM HEALTH
VA1790753225Medicaid
VA4545490004OtherCIGNA HMO
VA500617-5600455OtherAETNA PPO
VA541795091OtherFIRST HEALTH
VA223807OtherKAISER
VA4545490004OtherCIGNA HMO
VAG51802Medicare UPIN
VA000083F90Medicare PIN