Provider Demographics
NPI:1861524241
Name:MAPOU, ROBERT L (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:MAPOU
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:NASSAU
Mailing Address - State:DE
Mailing Address - Zip Code:19969-0073
Mailing Address - Country:US
Mailing Address - Phone:301-802-0538
Mailing Address - Fax:
Practice Address - Street 1:8401 CONNECTICUT AVE STE 1000
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815
Practice Address - Country:US
Practice Address - Phone:240-424-0184
Practice Address - Fax:240-580-2360
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002498103G00000X
DEB1-0001108103G00000X
MD2415103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD686017Medicare ID - Type Unspecified