Provider Demographics
NPI:1760626493
Name:VELBIS, ROBERT N (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:N
Last Name:VELBIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 GENERAL BOOTH BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-4861
Mailing Address - Country:US
Mailing Address - Phone:757-348-8604
Mailing Address - Fax:757-425-1582
Practice Address - Street 1:940 GENERAL BOOTH BLVD STE A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-4861
Practice Address - Country:US
Practice Address - Phone:757-425-3610
Practice Address - Fax:757-425-1582
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002936363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV5267A - C03895Medicare PIN