Healthcare Provider Details

I. General information

NPI: 1174967467
Provider Name (Legal Business Name): ROBERT MATTHEW FEUERSTEIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 TATE SPRINGS RD
LYNCHBURG VA
24501-1109
US

IV. Provider business mailing address

PO BOX 11646
LYNCHBURG VA
24506-1646
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-5895
  • Fax:
Mailing address:
  • Phone: 434-200-5895
  • Fax: 434-200-7529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102203971
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0102203971
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: