Provider Demographics
NPI:1598709677
Name:ADELAAR, ROBERT STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:ADELAAR
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 1:1200 E BROAD ST
Mailing Address - Street 2:MCV STATION BOX 980153
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5058
Mailing Address - Country:US
Mailing Address - Phone:804-828-9296
Mailing Address - Fax:804-828-4762
Practice Address - Street 1:1200 E BROAD ST
Practice Address - Street 2:MCV STATION BOX 980153
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5058
Practice Address - Country:US
Practice Address - Phone:804-828-9296
Practice Address - Fax:804-828-4762
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027258207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAAA7062285Medicare ID - Type UnspecifiedMEDICARE
VABO6672Medicare UPIN