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General NPI Number Information
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NPI Number | 1235784059
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Entity Type | Individual
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Provider Name | ROBERT LOGAN MIDDLEKAUFF PA
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Gender | Male
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 600 GRESHAM DR STE 8600
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City | NORFOLK
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State | VA
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Zip | 23507-1904
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Country | US
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Telephone | 757-388-6005
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 749112
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City | ATLANTA
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State | GA
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Zip | 30374-9112
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Country | US
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Telephone | 434-295-1000
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 0110006875
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License Number State | VA
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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 | 0110006875
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License Number State | VA
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