Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO00000249 | WA |
Y | 222Z00000X | Podiatrist | PO00000249 | WA |
N | 213ES0103X | Foot & Ankle Surgery | PO00000249 | WA |
NPI | 1013924836 |
---|---|
Provider Name | Robert Mcbride |
First Address | Tacoma, WA 98405 |
Second Address | Tacoma, WA 98405-1462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 31/07/2017 |