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NPI Code Detail

MEDICARE: MR. MICHAEL STEPHEN ROBERTSON RPH.

MEDICARE: MR. MICHAEL STEPHEN ROBERTSON RPH.
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
1183500000XPharmacist0202006088VA

General Provider Information

NPI Number : 1467545939
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL STEPHEN ROBERTSON RPH.
Provider Business Mailing Address
First Line : 6109 FORT AVE
Second Line :
City : LYNCHBURG
State : VA
Zip : 24502-1933
Country : US
Telephone Number : 434-239-2621
Fax Number : 434-239-3050
Provider Business Practice Location Address
First Line : 6109 FORT AVE
Second Line :
City : LYNCHBURG
State : VA
Zip : 24502-1933
Country : US
Telephone Number : 434-239-2621
Fax Number : 434-239-3050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/08/2007

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Directions to “ MR. MICHAEL STEPHEN ROBERTSON RPH.” Practice Location

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