Provider Demographics
NPI:1447370796
Name:LITTMAN, ROBERT LESLIE (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LESLIE
Last Name:LITTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:715 WILSON GREEN CT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1746
Mailing Address - Country:US
Mailing Address - Phone:410-967-4374
Mailing Address - Fax:410-377-4844
Practice Address - Street 1:6301 N CHARLES ST
Practice Address - Street 2:STE 8
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-1047
Practice Address - Country:US
Practice Address - Phone:410-377-6370
Practice Address - Fax:410-377-4844
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00254182084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5567OtherBS
MD127SMedicare ID - Type UnspecifiedMEDICARE