Basic Information
| Provider Information | |||||||||
| NPI: | 1447222088 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON-WALTON | ||||||||
| FirstName: | MAVA | ||||||||
| MiddleName: | BRIANA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WALTON | ||||||||
| OtherFirstName: | BRIANA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8110 MAPLE LAWN BLVD | ||||||||
| Address2: | STE 235 | ||||||||
| City: | FULTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207592694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013408339 | ||||||||
| FaxNumber: | 3013409027 | ||||||||
| Practice Location | |||||||||
| Address1: | 10301 GEORGIA AVE STE 205 | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209025020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015921600 | ||||||||
| FaxNumber: | 3015921602 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 10/11/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | D0060942 | MD | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | MD33866 | DC | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VF0040X | D60942 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
ID Information
| ID | Type | State | Issuer | Description | 511206100 | 05 | DC | MEDICAID | 7984083 | 01 | AETNA PPO | OTHER | 93604502 | 01 | BCBS MD | OTHER | D60942 | 01 | MD | STATE LICENSE | OTHER | 1782731 | 01 | AETNA HMO | OTHER | 006205551 | 05 | DC | MEDICAID | 034192800 | 05 | DC | MEDICAID | X3640002 | 01 | DC | BCBS | OTHER | 511206101 | 05 | MD | MEDICAID | 93604504 | 01 | MD | BCBS | OTHER | N4350001 | 01 | BCBS DC | OTHER | 010216249 | 05 | MD | MEDICAID | 93604503 | 01 | BCBS MARYLAND | OTHER |