Provider Demographics
NPI:1740422179
Name:SPENCER, ROBERT BLAIR (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BLAIR
Last Name:SPENCER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 ARCHER DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-5800
Mailing Address - Country:US
Mailing Address - Phone:757-277-5248
Mailing Address - Fax:
Practice Address - Street 1:528 ARCHER DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5800
Practice Address - Country:US
Practice Address - Phone:757-277-5248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202717207L00000X
PAOS014992207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology