=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750368791
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RONALD E ROBINSON MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2005
-----------------------------------------------------
Last Update Date | 04/20/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4900 COX RD STE 100 STE 100
-----------------------------------------------------
City | GLEN ALLEN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23060-6508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-346-1741
-----------------------------------------------------
Fax | 804-346-1799
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4900 COX RD STE 100
-----------------------------------------------------
City | GLEN ALLEN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23060-6508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-346-1746
-----------------------------------------------------
Fax | 804-346-1799
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | 0101048795
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------