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General NPI Number Information
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NPI Number | 1669541397
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Entity Type | Individual
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Provider Name | ROBERT LEE ALDERMAN PAC
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | FT. BELVOIR COMMUNITY HOSPITAL 9300 DEWITT LOOP
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City | FT. BELVOIR
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State | VA
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Zip | 22060-2206
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Country | US
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Telephone | 301-919-9592
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 S WASHINGTON ST APT 416
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4458
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Country | US
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Telephone | 301-919-9592
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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 | PA30009
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License Number State | DC
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