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NPI Code Detail

MEDICARE: ROBERT G SPERRY MD

MEDICARE: ROBERT G SPERRY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD00033454WA
2207Q00000XFamily Medicine PhysicianMD00033454WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417045550
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT G SPERRY MD
Provider Business Mailing Address
First Line : PO BOX 5127
Second Line :
City : EVERETT
State : WA
Zip : 98206-5127
Country : US
Telephone Number : 360-734-4404
Fax Number : 360-734-7409
Provider Business Practice Location Address
First Line : 3130 ELLIS ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-1904
Country : US
Telephone Number : 360-734-4404
Fax Number : 360-734-7409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 06/02/2021

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Directions to “ ROBERT G SPERRY MD” Practice Location

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