Provider Demographics
NPI:1154562130
Name:POOLEY, ROBERT EARL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EARL
Last Name:POOLEY
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 1:5129 RED STAG RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8638
Mailing Address - Country:US
Mailing Address - Phone:540-774-7835
Mailing Address - Fax:
Practice Address - Street 1:5129 RED STAG RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-8638
Practice Address - Country:US
Practice Address - Phone:540-774-7835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101018486207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology