Provider Demographics
NPI:1164576005
Name:STETEKLUH, ROBERT WILLIAM (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:STETEKLUH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6301 LITTLE RIVER TPKE
Mailing Address - Street 2:STE 110
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-5044
Mailing Address - Country:US
Mailing Address - Phone:703-524-2800
Mailing Address - Fax:703-524-9493
Practice Address - Street 1:4238 WILSON BLVD
Practice Address - Street 2:SUITE 3140
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1823
Practice Address - Country:US
Practice Address - Phone:703-524-2800
Practice Address - Fax:703-524-9493
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001004152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA06-1711971OtherTAX ID #