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NPI Code Detail

MEDICARE: ROBERT MEADE SIVERD III

MEDICARE: ROBERT MEADE SIVERD III
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
1222Z00000XOrthotist

General Provider Information

NPI Number : 1356667877
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT MEADE SIVERD III
Provider Business Mailing Address
First Line : 433 NETWORK STA
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-3851
Country : US
Telephone Number : 757-892-5300
Fax Number :
Provider Business Practice Location Address
First Line : 433 NETWORK STA
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-3851
Country : US
Telephone Number : 757-892-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2010
Last Update Date : 07/18/2022

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