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General NPI Number Information
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NPI Number | 1174580534
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Entity Type | Individual
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Provider Name | ROBERT SEAMUS WALSH PAC
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Gender | Male
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | PHY AMERICA 1435 CROSSWAYS BLVD STE 305
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City | CHESAPEAKE
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State | VA
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Zip | 23320
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Country | US
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Telephone | 757-424-7750
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Fax | 757-424-7754
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Provider Business Mailing Address
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Address Line | 1608 FLAMMARION COURT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-6910
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Country | US
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Telephone | 757-721-5456
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | NCCPA1027623
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110001830
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License Number State | VA
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