Healthcare Provider Details

I. General information

NPI: 1598694309
Provider Name (Legal Business Name): ROBERT REGAN MA EDUCATION
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 BELLEVUE AVE
RICHMOND VA
23227-4006
US

IV. Provider business mailing address

1505 BELLEVUE AVE
RICHMOND VA
23227-4006
US

V. Phone/Fax

Practice location:
  • Phone: 804-397-8493
  • Fax:
Mailing address:
  • Phone: 804-397-8493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number07018031
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: