Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | MD00025460 | WA |
NPI | 1184716144 |
---|---|
Provider Name | Dr. Robert Verne Wiggins |
First Address | Pullman, WA 99163-5517 |
Second Address | Pullman, WA 99163-5517 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000010004066 | BLUE SHIELD OF ID (01) | ID |
0007539 | LABOR AND INDUSTRIES (01) | |
003289500 | (05) | ID |
1046598 | (05) | WA |
8912267 | CVCP (01) | WA |
911408453 | FIRST CHOICE (01) | WA |
911408453 | GROUP HEALTH (01) | WA |
911408453 | MOLINA HEALTHCARE (01) | WA |
911408453 | PREMERA BLUE CROSS (01) | |
911408453 | UNITED HEALTHCARE (01) | |
D65706 | (02) | WA |
DEHV6 | BLUE CROSS OF ID (01) | ID |