| Doctor Name: | MR. ROBERT EDWARD MACDONNELL |
| NPI Number: | 1063710515 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OCCUPATIONAL THERAPI |
| License Number: | 0119002314 |
| Business Practice Address: | 700 Fettler Park Dumfries Health Center Dumfries, VA - 22025 |
| Business Phone Number: | 7034417500 |
| Business Fax Number: | |
| Mailing Address: | 3700 Fettler Park, Dumfries Health Center DUMFRIES |
| State: | VA |
| Postal Code: | 22025 |
| Phone Number: | 7034417500 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2011 |
| NPI Last Update Date: | 04/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | 0119002314 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |