Provider Demographics
NPI:1811904006
Name:TRIMARCHE, ROBERT J (PA-C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:TRIMARCHE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 VISTA PARK DR
Mailing Address - Street 2:STE A
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-4901
Mailing Address - Country:US
Mailing Address - Phone:434-200-9009
Mailing Address - Fax:434-200-9005
Practice Address - Street 1:1019 VISTA PARK DR
Practice Address - Street 2:STE A
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-4901
Practice Address - Country:US
Practice Address - Phone:434-200-9009
Practice Address - Fax:434-200-9005
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104127363A00000X
VA0110004190363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ29719Medicare UPIN
VAVV9326A696Medicare PIN
2762155AMedicare PIN