Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD00027498 | WA |
Y | 208600000X | Surgeon | MD00027498 | WA |
N | 208800000X | Urologist | MD00027498 | WA |
NPI | 1003965310 |
---|---|
Provider Name | Robert Dale Mcclure |
First Address | Seattle, WA 98101-1873 |
Second Address | Seattle, WA 98101-2756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 07/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0039595 | LABOR AND INDUSTRIES # (01) | WA |
8119356 | (05) | WA |
A24795 | (02) | |
MC8447 | BLUE SHIELD # (01) | WA |
MD894WA | (05) | AK |
US0861498 | AETNA SPECIALIST PIN (01) | WA |