Provider Demographics
NPI:1992772925
Name:ROBERT, NICHOLAS J (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:J
Last Name:ROBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8503 ARLINGTON BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4629
Mailing Address - Country:US
Mailing Address - Phone:703-280-5390
Mailing Address - Fax:703-280-9596
Practice Address - Street 1:8503 ARLINGTON BLVD
Practice Address - Street 2:STE 400
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4629
Practice Address - Country:US
Practice Address - Phone:703-280-5390
Practice Address - Fax:703-280-9596
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101046864207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0870-005OtherBCBS NCA CARE FIRST
VA1992772925Medicaid
VA5983432004OtherCIGNA POS/PPO
VA112924OtherKAISER
VA500617-500599OtherAETNA HMO
VA145010OtherSOUTHERN HEALTH
VA3000002OtherUNITED HEALTHCARE
VA316256-516255OtherMAMSI/OP CHOICE/ALLIANCE
VA541795091OtherPHCS PPO/POS
VA220659OtherTRIGON/ANTHEM
VA5983432004OtherCIGNA HMO
VA500617-4141420OtherAETNA PPO
VA504741OtherNCPPO
VA145010OtherSOUTHERN HEALTH
VA3000002OtherUNITED HEALTHCARE
VA500617-500599OtherAETNA HMO
VA694835F90Medicare PIN