Provider Demographics
NPI:1235146192
Name:ROBINSON, GROVER C IV (MD)
Entity Type:Individual
Prefix:
First Name:GROVER
Middle Name:C
Last Name:ROBINSON
Suffix:IV
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 1:400 WESTHAMPTON STA
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3330
Mailing Address - Country:US
Mailing Address - Phone:804-287-4200
Mailing Address - Fax:804-287-4210
Practice Address - Street 1:400 WESTHAMPTON STA
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226
Practice Address - Country:US
Practice Address - Phone:804-287-4200
Practice Address - Fax:804-287-4210
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238929207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNCB9874OtherRAILROAD MEDICARE
TN3815285Medicaid
TN3815285Medicaid
TN3815285Medicare PIN
TNCB9874OtherRAILROAD MEDICARE