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1093707606

NPI Code Detail

MEDICARE: MR. ROBERT J MENDEZ DO

MEDICARE: MR. ROBERT J MENDEZ DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	0102036928	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150684200	OTHER		OWCP FED WC VIA ACS
2	265207	OTHER		BCBS OF VA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	A1798	OTHER		MEDCOST
5	10010981	OTHER	VA	SENTARA
6	265207	OTHER		PENINSULA HEALTHCARE INC
7	54-1951442	OTHER		CORVEL WC PROVIDER NETWOR
8	9803412001	OTHER		CIGNA
9	10010981	OTHER	VA	SENTARA PPO
10	54-1951442	OTHER		MIDATLANTIC HEALTH SOLUTI
11	54-1951442	OTHER	VA	HEALTH NETWORK
12	200374	OTHER	VA	PHYSICIAN NETWORK
13	265207	OTHER		PRIORITY HEALTH CARE INC
14	54-1951442	OTHER		AETNA
15	265207	OTHER		HEALTHKEEPERS
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093707606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT J MENDEZ DO

Provider Business Mailing Address
First Line	:	3315 HIGH ST
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-3319
Country	:	US
Telephone Number	:	757-399-0759
Fax Number	:	757-397-8957

Provider Business Practice Location Address
First Line	:	3315 HIGH ST
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-3319
Country	:	US
Telephone Number	:	757-399-0759
Fax Number	:	757-397-8957

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	03/24/2011

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1295727105 — MR. DONALD HOLZER MD
Practice Location Address:

3315 HIGH ST
PORTSMOUTH, VA
23707-3319

Practice Phone: 757-399-0759
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1467444075 — MR. WILLIAM LUVERNE LITTLE JR. DO
Practice Location Address:

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1396847778 — ROBERTA MARY STEWART MSN RN FNP
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Practice Phone: 757-399-0759
Practice Fax: 757-399-3892

1962682534 — MRS. KATIE JANE GERARGE PA-C
Practice Location Address:

3315 HIGH ST
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23707-3319

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1871802413 — MARYVIEW HOSPITAL
Practice Location Address:

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1538460837 — BOBBI JO OLDAKER FNP
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Directions to “ MR. ROBERT J MENDEZ DO” Practice Location

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