Provider Demographics
NPI:1801820964
Name:GINSBERG, ROBERT JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAY
Last Name:GINSBERG
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 1:3905 NATIONAL DRIVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-6106
Mailing Address - Country:US
Mailing Address - Phone:240-389-1192
Mailing Address - Fax:240-389-1186
Practice Address - Street 1:3905 NATIONAL DRIVE
Practice Address - Street 2:SUITE 220
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-6106
Practice Address - Country:US
Practice Address - Phone:240-389-1192
Practice Address - Fax:240-389-1186
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD25344207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD31339-1500Medicaid
MD4244044OtherCIGNA PIN
MD8160542OtherALLIANCE PIN
MD8160542OtherOPTIMUM CHOICE
MD521186611OtherUNITED HEALTHCARE
MD8160542OtherMDIPA PIN
MD9070 0034OtherBSDC PIN
MD41417103OtherBSMD PIN
MD816542OtherMAMSI PIN
MD8160542OtherMDIPA PIN
MD31339-1500Medicaid