MEDICARE: MR. ROBERT J. NORGROVE PA-C

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	363A00000X	Physician Assistant	MA053190	PA
2	363A00000X	Physician Assistant	0110004565	VA

General Provider Information

NPI Number	:	1467633974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT J. NORGROVE PA-C

Provider Business Mailing Address
First Line	:	11110 MEDICAL CAMPUS RD
Second Line	:	STE 205
City	:	HAGERSTOWN
State	:	MD
Zip	:	21742-6797
Country	:	US
Telephone Number	:	301-665-4950
Fax Number	:	301-665-4950

Provider Business Practice Location Address
First Line	:	9166 N CONGRESS ST
Second Line	:
City	:	NEW MARKET
State	:	VA
Zip	:	22844-9422
Country	:	US
Telephone Number	:	540-459-1380
Fax Number	:	540-459-1349

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

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	04/04/2016

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