Healthcare Provider Details

I. General information

NPI: 1265735336
Provider Name (Legal Business Name): ROBERT LINWOOD HEWITT III PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 HIGH ST W
PORTSMOUTH VA
23703-3758
US

IV. Provider business mailing address

924 SAINT ANDREWS REACH APT A
CHESAPEAKE VA
23320-8526
US

V. Phone/Fax

Practice location:
  • Phone: 757-686-8257
  • Fax:
Mailing address:
  • Phone: 757-686-8257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202210061
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: