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NPI Code Detail

MEDICARE: ROBERT AMICK MD

MEDICARE: ROBERT AMICK 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
1207Q00000XFamily Medicine Physician0101-036989VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2382641OTHERVAANTHEM

General Provider Information

NPI Number : 1902878051
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT AMICK MD
Provider Business Mailing Address
First Line : 5025 BALSAM DR
Second Line :
City : ROANOKE
State : VA
Zip : 24018-4805
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6415 PETERS CREEK RD
Second Line :
City : ROANOKE
State : VA
Zip : 24019-4021
Country : US
Telephone Number : 540-265-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 08/11/2011

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