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Individual

ROBERT MCDONNELL

Active
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Individual

ROBERT MCDONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT, MDT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
J10001531
DE
225100000X
Physical Therapist
Primary
PT014034L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000037716
DE
01
1039897
PABS
01
1104868900
CHAMPUS
01
11416967
CAQH
01
1309897
PABS
PA
01
2003135000
IBC
01
292670
MAMSI
01
5070-0091
NCA
01
92839701
CAREFIRST
Enumeration date
06/13/2006
Last updated
05/03/2017
About Stedi
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