Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 0401007031 | VA |
NPI | 1114997533 |
---|---|
Provider Name | Dr. Robert William Schutt |
First Address | Yorktown, VA 23693-3628 |
Second Address | Norfolk, VA 23511-2803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 08/07/2007 |