Individual
MR. ROBERT BLAINE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6275 E VIRGINIA BEACH BLVD, SUITE 303, NORFOLK, VA 23502-2851
(757) 461-3141
(757) 461-1658
Mailing address
6275 E VIRGINIA BEACH BLVD, SUITE 303, NORFOLK, VA 23502-2851
(757) 461-3141
(757) 461-1658
Taxonomy
Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
0101041467
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01927504
—
NY
01
—
130020497
MEDICARE RAILROAD
VA
01
—
15005
SENTRA PPO
—
01
—
150684200
OWCP FED WC VIA ACS
VA
01
—
265200
BCBS
VA
01
—
265200
PRIORITY HEALTH CARE INC
—
01
—
3336466004
CIGNA
—
01
—
54-1951442
HEALTH NETWORK
VA
01
—
54-1951442
AETNA
—
01
—
64452
MEDCOST
—
01
—
7112378
PREMIER HEALTH PLAN
VA
05
—
7112378
—
VA
05
—
890593R
—
NC
Enumeration date
08/19/2005
Last updated
04/06/2016
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