Provider Demographics
NPI:1891887014
Name:ROBERT J PATTERSON, MD LLC
Entity Type:Organization
Organization Name:ROBERT J PATTERSON, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-745-0450
Mailing Address - Street 1:800 S TALBOT ST
Mailing Address - Street 2:
Mailing Address - City:ST MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663-2628
Mailing Address - Country:US
Mailing Address - Phone:410-745-0450
Mailing Address - Fax:410-745-0452
Practice Address - Street 1:800 S TALBOT ST
Practice Address - Street 2:
Practice Address - City:ST MICHAELS
Practice Address - State:MD
Practice Address - Zip Code:21663-2628
Practice Address - Country:US
Practice Address - Phone:410-745-0450
Practice Address - Fax:410-745-0452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD515MMedicare ID - Type Unspecified