Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 0101038221 | VA |
NPI | 1164510277 |
---|---|
Provider Name | Dr. Robert Morton Treherne |
First Address | Hampton, VA 23666 |
Second Address | Hampton, VA 23666 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6200311 | (05) | VA |
B07517 | (02) |