Provider Demographics
NPI:1780974345
Name:PAINE, ROBERT TIMOTHY (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TIMOTHY
Last Name:PAINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3203 ROLLING GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028-1311
Mailing Address - Country:US
Mailing Address - Phone:304-807-5522
Mailing Address - Fax:571-260-5193
Practice Address - Street 1:1212 E CHURCHVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3481
Practice Address - Country:US
Practice Address - Phone:410-428-0018
Practice Address - Fax:571-260-5193
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH00773922084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry