Provider Demographics
NPI:1659388981
Name:DURR, ROBERT A (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:DURR
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 1:2210 WILBORN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-1630
Mailing Address - Country:US
Mailing Address - Phone:434-575-5864
Mailing Address - Fax:434-575-8929
Practice Address - Street 1:2210 WILBORN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-1630
Practice Address - Country:US
Practice Address - Phone:434-575-5864
Practice Address - Fax:434-575-8929
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033333207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2155860OtherSOUTHERN HEALTH
VA208423OtherANTHEM BCBS
VA435502OtherSOUTHERN HEALTH
VA2155860OtherSOUTHERN HEALTH
VA011502P76Medicare ID - Type Unspecified