Healthcare Provider Details

I. General information

NPI: 1730402017
Provider Name (Legal Business Name): ROBERT CHRISTOPHER VIETOR III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 COMMONWEALTH AVE
WILLIAMSBURG VA
23185-5229
US

IV. Provider business mailing address

4301 JONES BRIDGE RD
BETHESDA MD
20814-4799
US

V. Phone/Fax

Practice location:
  • Phone: 757-585-2200
  • Fax:
Mailing address:
  • Phone: 240-782-5203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD81025
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101250834
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: