Provider Demographics
NPI:1982024378
Name:BAILLIEU, ROBERT LATHAM (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LATHAM
Last Name:BAILLIEU
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Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:1400 I (EYE) STREET NW
Mailing Address - Street 2:SUITE 825
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005
Mailing Address - Country:US
Mailing Address - Phone:202-617-2160
Mailing Address - Fax:410-367-2248
Practice Address - Street 1:1400 I (EYE) STREET NW
Practice Address - Street 2:SUITE 825
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005
Practice Address - Country:US
Practice Address - Phone:202-617-2160
Practice Address - Fax:410-367-2248
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2020-04-07
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD82747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program