Provider Demographics
NPI:1831181775
Name:HSIEH, ROBERT C (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:HSIEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 KENILWORTH AVE
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1339
Mailing Address - Country:US
Mailing Address - Phone:301-699-1166
Mailing Address - Fax:301-209-9456
Practice Address - Street 1:6510 KENILWORTH AVE
Practice Address - Street 2:SUITE 1300
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1339
Practice Address - Country:US
Practice Address - Phone:301-699-1166
Practice Address - Fax:301-209-9456
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0017307174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDHS410104Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MDB94673Medicare UPIN