Provider Demographics
NPI:1821039496
Name:BENNETT, ROBERT MACINTYRE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MACINTYRE
Last Name:BENNETT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8001 FRANKLIN FARMS DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5108
Mailing Address - Country:US
Mailing Address - Phone:804-521-5800
Mailing Address - Fax:804-545-4340
Practice Address - Street 1:658 HOSPITAL RD
Practice Address - Street 2:SUITE 302
Practice Address - City:TAPPAHANNOCK
Practice Address - State:VA
Practice Address - Zip Code:22560-5000
Practice Address - Country:US
Practice Address - Phone:804-443-6235
Practice Address - Fax:804-443-6239
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101024513207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5102802OtherMAMSI
VA1432711OtherCIGNA
VA4063276OtherAETNA US HEALTHCARE
VA103789OtherANTHEM/VA HEALTHKEEPERS
VI3257137OtherAETNA US HEALTHCARE HMO
VA72764OtherOPTIMA HEALTH
VA463048OtherANTHEM/VA HEALTHKEEPERS
VA010009120Medicaid
VA296195OtherSOUTHERN HEALTH
VA27413300OtherFEDERAL BLACK LUNG
VAP00029402OtherRAILROAD MEDICARE
VAP00029402OtherRAILROAD MEDICARE
VA463048OtherANTHEM/VA HEALTHKEEPERS