Healthcare Provider Details

I. General information

NPI: 1285793406
Provider Name (Legal Business Name): ROBERT JOHN FIERRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 BREMO RD SUITE 701
RICHMOND VA
23226-1934
US

IV. Provider business mailing address

5875 BREMO RD SUITE 701
RICHMOND VA
23226-1934
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-8350
  • Fax: 804-282-6506
Mailing address:
  • Phone: 804-282-8350
  • Fax: 804-282-6506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0101026356
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: