Healthcare Provider Details

I. General information

NPI: 1962421040
Provider Name (Legal Business Name): ROBERT E SPERRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7611 FOREST AVE SUITE 100
RICHMOND VA
23229-4946
US

IV. Provider business mailing address

8001 FRANKLIN FARMS DR SUITE 700
RICHMOND VA
23229-5108
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-4827
  • Fax: 804-288-4494
Mailing address:
  • Phone: 804-521-5800
  • Fax: 804-545-4340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number0101045319
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101045319
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: