Provider Demographics
NPI:1386910370
Name:SHROYER, ROBERT JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOSEPH
Last Name:SHROYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3201 JERMANTOWN RD STE 550
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2885
Mailing Address - Country:US
Mailing Address - Phone:703-667-8600
Mailing Address - Fax:703-667-8601
Practice Address - Street 1:5500 KNOLL NORTH DR STE 190
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2487
Practice Address - Country:US
Practice Address - Phone:443-917-2700
Practice Address - Fax:410-415-1418
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-24
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0468992085R0202X
MDD870012085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology