1174583694 NPI number — ROBERT D. LEHMAN, M.D., P.C

Table of content: (NPI 1174583694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174583694 NPI number — ROBERT D. LEHMAN, M.D., P.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT D. LEHMAN, M.D., P.C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PEDIATRIC AFFILIATES OF HAMPTON ROADS
Provider Other Organization Name Type Code:
3
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:
1174583694
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 GRAYSON RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23462-3745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-473-3200
Provider Business Mailing Address Fax Number:
757-473-0459

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 GRAYSON RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23462-3745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-473-3200
Provider Business Practice Location Address Fax Number:
757-473-0459
Provider Enumeration Date:
03/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEHMAN
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
DIRECT OWNER
Authorized Official Telephone Number:
757-473-3200

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  0101041118 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 006740294 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 066168 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0101041118 . This is a "STATE ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 6000103074 . This is a "CIGNA ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 13027 . This is a "OPTIMA HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 231543 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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