Healthcare Provider Details

I. General information

NPI: 1497713523
Provider Name (Legal Business Name): ROBERT CHARLES DEARNLEY P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 KINGSLEY LN
NORFOLK VA
23505-4602
US

IV. Provider business mailing address

860 OMNI BLVD STE 303
NEWPORT NEWS VA
23606-4477
US

V. Phone/Fax

Practice location:
  • Phone: 757-889-5157
  • Fax:
Mailing address:
  • Phone: 757-232-8769
  • Fax: 757-232-8875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110001595
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: