Healthcare Provider Details

I. General information

NPI: 1588740385
Provider Name (Legal Business Name): ROBERT MICHAEL KALUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N 115TH ST D-149B
SEATTLE WA
98133-8401
US

IV. Provider business mailing address

6113 24TH AVE NE
SEATTLE WA
98115-7023
US

V. Phone/Fax

Practice location:
  • Phone: 206-368-1500
  • Fax: 206-368-1503
Mailing address:
  • Phone: 206-632-2505
  • Fax: 206-368-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD00039956
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00039956
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: