Provider Demographics
NPI:1790802361
Name:PY, ROBERT C (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:PY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5777 PRINCESS ANNE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3224
Mailing Address - Country:US
Mailing Address - Phone:757-490-9717
Mailing Address - Fax:757-490-9714
Practice Address - Street 1:5777 PRINCESS ANNE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3224
Practice Address - Country:US
Practice Address - Phone:757-490-9717
Practice Address - Fax:757-490-9714
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA178395OtherANTHEM BC