=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528035763
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT EMMETT WEHMANN M.D., PH.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2006
-----------------------------------------------------
Last Update Date | 11/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 518 REBEL RIDGE RD
-----------------------------------------------------
City | SOUTH CHESTERFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23834-5835
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-914-3479
-----------------------------------------------------
Fax | 201-664-8705
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 518 REBEL RIDGE RD
-----------------------------------------------------
City | SOUTH CHESTERFIELD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23834-5835
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-914-3479
-----------------------------------------------------
Fax | 201-664-8705
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | MA54166
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------