Provider Demographics
NPI:1790932499
Name:ROBERTSON, KESHA SHUNTE (MD)
Entity Type:Individual
Prefix:DR
First Name:KESHA
Middle Name:SHUNTE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 HOSPITAL ROAD
Mailing Address - Street 2:ATTN: CONTRACTING & CREDENTIALING COORDINATOR
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678
Mailing Address - Country:US
Mailing Address - Phone:410-414-4791
Mailing Address - Fax:410-414-2721
Practice Address - Street 1:110 HOSPITAL RD STE 203
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4045
Practice Address - Country:US
Practice Address - Phone:410-414-4740
Practice Address - Fax:410-414-4741
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2021-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN4041207V00000X
TN57684207V00000X
MDD85185207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty