Individual
ROBERT M HALLIVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3998 FAIR RIDGE DR STE 280, FAIRFAX, VA 22033-2907
(703) 849-8400
(703) 849-8448
Mailing address
3998 FAIR RIDGE DR STE 280, FAIRFAX, VA 22033-2907
(703) 849-8400
(703) 849-8448
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
0103300812
VA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103300812
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009300082
—
VA
01
—
140164
ANTHEM
—
01
—
1984179
UNITED HEALTH CARE
—
01
—
281433
MDIPA
—
01
—
3307-0003
CAREFIRST
—
Enumeration date
08/03/2005
Last updated
09/12/2022
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