Provider Demographics
NPI:1447383658
Name:MENY, ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MENY
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 1:11419 CRONRIDGE DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6281
Mailing Address - Country:US
Mailing Address - Phone:410-902-4614
Mailing Address - Fax:410-902-8247
Practice Address - Street 1:9103 FRANKLIN SQUARE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3900
Practice Address - Country:US
Practice Address - Phone:410-682-5282
Practice Address - Fax:410-682-5286
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0029553208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD34184007OtherBS BS MARYLAND
776718OtherUNITED
MDE5540026OtherBLUE CHOICE
K531J634Medicare ID - Type UnspecifiedTRAILBLAZERS
B45451Medicare UPIN