MEDICARE: ROBERT ANDREW WHISNANT MD

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
1	208800000X	Urology Physician		VA

General Provider Information

NPI Number	:	1609863513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ANDREW WHISNANT MD

Provider Business Mailing Address
First Line	:	102 HIGHLAND AVE SE
Second Line	:	SUITE 105
City	:	ROANOKE
State	:	VA
Zip	:	24013-2256
Country	:	US
Telephone Number	:	540-343-8066
Fax Number	:	540-343-5369

Provider Business Practice Location Address
First Line	:	102 HIGHLAND AVE SE
Second Line	:	SUITE 105
City	:	ROANOKE
State	:	VA
Zip	:	24013-2256
Country	:	US
Telephone Number	:	540-343-8066
Fax Number	:	540-343-5369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	07/08/2007

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