Provider Demographics
NPI:1689627911
Name:D'HAEM, ROBERT JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:D'HAEM
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 KINGSLEY LN
Mailing Address - Street 2:STE 305
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4614
Mailing Address - Country:US
Mailing Address - Phone:757-889-5422
Mailing Address - Fax:757-889-5450
Practice Address - Street 1:110 KINGSLEY LN
Practice Address - Street 2:STE 305
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4614
Practice Address - Country:US
Practice Address - Phone:757-889-5422
Practice Address - Fax:757-889-5450
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010343702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA300043436OtherRAILROAD MEDICARE
VA007238878Medicaid
VAF32587Medicare UPIN
VA300043436OtherRAILROAD MEDICARE