Provider Demographics
NPI:1164471421
Name:HODGE, ROBERT HENRY (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:HENRY
Last Name:HODGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2764 BROWNS GAP TPKE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-5112
Mailing Address - Country:US
Mailing Address - Phone:434-823-4161
Mailing Address - Fax:
Practice Address - Street 1:2764 BROWNS GAP TPKE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-5112
Practice Address - Country:US
Practice Address - Phone:434-823-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine