Provider Demographics
NPI:1740283704
Name:OPET, ROBERT F (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:OPET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:138 S ROSEMONT RD
Mailing Address - Street 2:STE 215
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4336
Mailing Address - Country:US
Mailing Address - Phone:757-431-9551
Mailing Address - Fax:757-431-9663
Practice Address - Street 1:138 S ROSEMONT RD
Practice Address - Street 2:STE 215
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4336
Practice Address - Country:US
Practice Address - Phone:757-431-9551
Practice Address - Fax:757-431-9663
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101050652207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA024547OtherANTHEM OF VIRGINIA
NC0601TOtherBC BS OF NORTH CAROLINA
NC890601TMedicaid
VA11141OtherOPTIMA SENTARA
VA11141OtherOPTIMA SENTARA