1336395581 NPI number — DR. ROBERT NOLAN UNISZKIEWICZ MD

Table of content: DR. ROBERT NOLAN UNISZKIEWICZ MD (NPI 1336395581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336395581 NPI number — DR. ROBERT NOLAN UNISZKIEWICZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UNISZKIEWICZ
Provider First Name:
ROBERT
Provider Middle Name:
NOLAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336395581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
620 JOHN PAUL JONES CIR
Provider Second Line Business Mailing Address:
OCCUPATIONAL HEALTH
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23708-2111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-953-9703
Provider Business Mailing Address Fax Number:
757-953-7552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 JOHN PAUL JONES CIR
Provider Second Line Business Practice Location Address:
OCCUPATIONAL HEALTH
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23708-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-953-9703
Provider Business Practice Location Address Fax Number:
757-953-7552
Provider Enumeration Date:
08/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2083P0500X , with the licence number:  AL29992 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: AL29992 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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