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Individual

DR. PHILIP BRUNNER ROBERTSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
105 WESTWOOD CMN, BLUEFIELD, VA 24605-2031
(276) 326-2686
Mailing address
347 SANDPIPER AVE, PRINCETON, WV 24740-4185
(304) 425-2620

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101044622
VA
2084P0800X
Psychiatry Physician
15604
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0114647000
WV
05
7107340
VA
Enumeration date
03/25/2006
Last updated
06/27/2008
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