Provider Demographics
NPI:1821222183
Name:ROBERT C DART MD PLC
Entity Type:Organization
Organization Name:ROBERT C DART MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:DART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-347-1113
Mailing Address - Street 1:9174 HARTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-8536
Mailing Address - Country:US
Mailing Address - Phone:540-347-1113
Mailing Address - Fax:540-678-9025
Practice Address - Street 1:493 BLACKWELL RD
Practice Address - Street 2:SUITE 101A
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2628
Practice Address - Country:US
Practice Address - Phone:540-347-1113
Practice Address - Fax:540-678-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035419207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1821222183Medicaid
VAC10740Medicare PIN