Provider Demographics
NPI:1093976227
Name:SEALAND, ROBERT O II (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:O
Last Name:SEALAND
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8266 ATLEE RD
Mailing Address - Street 2:SUITE 332
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1804
Mailing Address - Country:US
Mailing Address - Phone:804-764-7686
Mailing Address - Fax:804-764-7689
Practice Address - Street 1:8266 ATLEE RD
Practice Address - Street 2:SUITE 332
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1804
Practice Address - Country:US
Practice Address - Phone:804-764-7686
Practice Address - Fax:804-764-7689
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249623207R00000X
390200000X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06115OtherGROUP PTAN