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NPI Code Detail

MEDICARE: ROBERT KNOWLES M.D.

MEDICARE: ROBERT KNOWLES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WW0000XWound Care Registered Nurse0101058403VA
2208600000XSurgery Physician15835NH
3208600000XSurgery Physician0101058403VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1002960301OTHERNHMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013915602
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT KNOWLES M.D.
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number : 540-224-5715
Fax Number : 540-224-5684
Provider Business Practice Location Address
First Line : 101 ELM AVE SE
Second Line :
City : ROANOKE
State : VA
Zip : 24013-2222
Country : US
Telephone Number : 540-224-4325
Fax Number : 540-224-4399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 08/23/2022

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