Trace, Robert John

Trace, Robert John is an sole proprietor health care provider with primary practice located at 121 E Antietam St , Hagerstown MD 21740. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Trace, Robert John can be contacted via phone (301) 739-2560.

Contact Information

Primary practice address
121 E Antietam St Hagerstown MD 21740
Phone: (301) 739-2560
Fax: (301) 739-0266
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X D22012 Maryland

Profile Details

NPI number 1801869961
LBN Legal business name Trace, Robert John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2006
Last updated Jul 16th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801869961 NPPES
Maryland Other W0180001 BLUE CROSS BLUE SHIELD
Maryland MEDICAID 964111400 BLUE CROSS BLUE SHIELD

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