Healthcare Provider Details

I. General information

NPI: 1801903745
Provider Name (Legal Business Name): ROBERT SEIM OD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4217 VIRGINIA BEACH BLVD
VIRGINIA BEACH VA
23452-1232
US

IV. Provider business mailing address

4217 VIRGINIA BEACH BLVD
VIRGINIA BEACH VA
23452-1232
US

V. Phone/Fax

Practice location:
  • Phone: 757-340-7070
  • Fax: 757-340-7500
Mailing address:
  • Phone: 757-340-7070
  • Fax: 757-340-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number0618000932
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number0618000932
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618000932
License Number StateVA

VIII. Authorized Official

Name: DR. ROBERT P SEIM
Title or Position: OWNER
Credential: OD
Phone: 757-340-7070