Provider Demographics
NPI:1487612263
Name:LAVIN, ROBERT ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:LAVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:DEPT. OF NEUROLOGY, BALTIMORE VA, SUITE 4A-150
Mailing Address - Street 2:10 NORTH GREENE STREET; BT-127
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-605-7448
Mailing Address - Fax:410-605-7937
Practice Address - Street 1:10 N GREENE ST., SUITE 4A-150
Practice Address - Street 2:BT - 127, DEPT. OF NEUROLOGY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7448
Practice Address - Fax:410-605-7937
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00350842081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD190281460Medicaid
MD190281460Medicaid
MD530315Medicare PIN