Healthcare Provider Details

I. General information

NPI: 1992802227
Provider Name (Legal Business Name): ROBERT HART PRASSE II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35070-A GERMANNA HEIGHTS DR
LOCUST GROVE VA
22508-3108
US

IV. Provider business mailing address

35070 GERMANNA HEIGHTS DR SUITE A
LOCUST GROVE VA
22508-3108
US

V. Phone/Fax

Practice location:
  • Phone: 540-423-1788
  • Fax: 540-423-1755
Mailing address:
  • Phone: 540-423-1788
  • Fax: 540-423-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101058277
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: