Provider Demographics
NPI:1992783021
Name:ROBEY, EDWIN L (MD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:L
Last Name:ROBEY
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 1:225 CLEARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1815
Mailing Address - Country:US
Mailing Address - Phone:757-452-3480
Mailing Address - Fax:757-452-3482
Practice Address - Street 1:225 CLEARFIELD AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1815
Practice Address - Country:US
Practice Address - Phone:757-452-3480
Practice Address - Fax:757-452-3482
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010388865208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA52626OtherSENTARA HEALTHCARE
VA007501579Medicaid
VA331815OtherANTHEM BC BS
B08581Medicare UPIN
VA007501579Medicaid
VA52626OtherSENTARA HEALTHCARE