Provider Demographics
NPI:1821067000
Name:JANKE, ROBIN MCHUGH (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MCHUGH
Last Name:JANKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E BROAD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4520
Mailing Address - Country:US
Mailing Address - Phone:703-532-5436
Mailing Address - Fax:703-532-3232
Practice Address - Street 1:131 E BROAD ST STE 102
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4520
Practice Address - Country:US
Practice Address - Phone:703-532-5436
Practice Address - Fax:703-532-3232
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065739207Q00000X
VA0101253061207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI10-4995039Medicaid
MI10-4995039Medicaid