Individual
ROBERT LOWELL HETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
224D CORNWALL ST NW, SUITE 106, LEESBURG, VA 20176-2700
(703) 777-1612
(703) 777-2368
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101232586
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010105706
—
VA
05
—
010105731
—
VA
05
—
010105757
—
VA
01
—
P00270260
RR MEDICARE
—
Enumeration date
08/30/2005
Last updated
01/09/2010
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