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General NPI Number Information
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NPI Number | 1164576005
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Entity Type | Individual
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Provider Name | ROBERT WILLIAM STETEKLUH O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 12/03/2018
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Provider Practice Location Address
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Address Line | 4238 WILSON BLVD SUITE 3140
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City | ARLINGTON
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State | VA
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Zip | 22203-1823
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Country | US
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Telephone | 703-524-2800
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Fax | 703-524-9493
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Provider Business Mailing Address
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Address Line | 6301 LITTLE RIVER TPKE STE 110
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City | ALEXANDRIA
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State | VA
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Zip | 22312-5044
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Country | US
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Telephone | 703-524-2800
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Fax | 703-524-9493
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618001004
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License Number State | VA
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