Provider Demographics
NPI:1376785337
Name:ROBERTS, SETH BELOTE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:BELOTE
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8580 MAGELLAN PKWY
Mailing Address - Street 2:BUILDING IV
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1149
Mailing Address - Country:US
Mailing Address - Phone:804-627-5291
Mailing Address - Fax:804-627-5370
Practice Address - Street 1:8580 MAGELLAN PKWY
Practice Address - Street 2:BUILDING IV
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1149
Practice Address - Country:US
Practice Address - Phone:804-627-5291
Practice Address - Fax:804-627-5370
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240660207PH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06778OtherGROUP PTAN