Provider Demographics
NPI:1588600761
Name:CHILDERS, ROBERT STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEVEN
Last Name:CHILDERS
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 1:110 HOUSTON ST STE D
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2437
Mailing Address - Country:US
Mailing Address - Phone:540-462-3950
Mailing Address - Fax:540-464-4449
Practice Address - Street 1:110 HOUSTON ST STE D
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2437
Practice Address - Country:US
Practice Address - Phone:540-462-3950
Practice Address - Fax:540-464-4449
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101259348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00235145OtherRAILROAD MEDICARE
OH0699034Medicaid
WV3810002979Medicaid
4161781Medicare PIN
P00235145OtherRAILROAD MEDICARE