Provider Demographics
NPI:1790748036
Name:HONEA, ROBERT H (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:HONEA
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 1:159 EXECUTIVE DRIVE
Mailing Address - Street 2:STE B
Mailing Address - City:DAVVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541
Mailing Address - Country:US
Mailing Address - Phone:434-792-5964
Mailing Address - Fax:434-792-5971
Practice Address - Street 1:159 EXECUTIVE DRIVE
Practice Address - Street 2:STE B
Practice Address - City:DAVVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541
Practice Address - Country:US
Practice Address - Phone:434-792-5964
Practice Address - Fax:434-792-5971
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034715208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA730017Medicaid
VA020033005OtherRAILROAD MEDICARE
VA280598OtherANTHEM
VA280598OtherANTHEM
VA730017Medicaid