Provider Demographics
NPI:1205812971
Name:SEIM, ROBERT P (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:SEIM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4217 VIRGINIA BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1232
Mailing Address - Country:US
Mailing Address - Phone:757-340-7070
Mailing Address - Fax:757-340-7500
Practice Address - Street 1:4217 VIRGINIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1232
Practice Address - Country:US
Practice Address - Phone:757-340-7070
Practice Address - Fax:757-340-7500
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA601800096152W00000X, 152WC0802X, 152WP0200X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
51-0558604OtherTAXID CORP
VA401989252OtherTRICARE
VAU78475Medicare UPIN
VA5725370001Medicare NSC
VA1801903745Medicare NSC