Provider Demographics
NPI:1891792461
Name:LYNN, ROBERT (MD, PA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:LYNN
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2302
Mailing Address - Country:US
Mailing Address - Phone:301-777-0620
Mailing Address - Fax:301-777-2906
Practice Address - Street 1:134 BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2302
Practice Address - Country:US
Practice Address - Phone:301-777-0620
Practice Address - Fax:301-777-2906
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
MDD00555642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC06152Medicare UPIN
MD846M540FMedicare ID - Type Unspecified