Healthcare Provider Details

I. General information

NPI: 1770548109
Provider Name (Legal Business Name): CHERYL K ROBSON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERYL K KANE OD

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 CEDAR CREEK GRADE SUITE 100
WINCHESTER VA
22601-2705
US

IV. Provider business mailing address

905 CEDAR CREEK GRADE SUITE 100
WINCHESTER VA
22601-2705
US

V. Phone/Fax

Practice location:
  • Phone: 540-665-0541
  • Fax: 540-665-8286
Mailing address:
  • Phone: 540-665-0541
  • Fax: 540-665-8286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618000117
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: