Provider Demographics
NPI:1063590172
Name:PITSENBARGER, ROBERT P (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:PITSENBARGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 GREAT BRIDGE BLVD.
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320
Mailing Address - Country:US
Mailing Address - Phone:757-547-9334
Mailing Address - Fax:757-819-6292
Practice Address - Street 1:224 GREAT BRIDGE BLVD.
Practice Address - Street 2:CHESAPEAKE COMM SERV BOARD
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-547-9334
Practice Address - Fax:757-819-6292
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010565792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5623065Medicaid
VA324645OtherTRICARE FED H MET
VA185017OtherANTHEM TRIGON
VA185017OtherANTHEM TRIGON
007541C89Medicare PIN