Provider Demographics
NPI:1669541397
Name:ALDERMAN, ROBERT LEE (PAC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEE
Last Name:ALDERMAN
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1204 S WASHINGTON ST APT 416
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4458
Mailing Address - Country:US
Mailing Address - Phone:301-919-9592
Mailing Address - Fax:
Practice Address - Street 1:FT. BELVOIR COMMUNITY HOSPITAL
Practice Address - Street 2:9300 DEWITT LOOP
Practice Address - City:FT. BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-2206
Practice Address - Country:US
Practice Address - Phone:301-919-9592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA30009363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant