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General NPI Number Information
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NPI Number | 1013924836
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Entity Type | Individual
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Provider Name | ROBERT MCBRIDE DPM
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4050 S 19TH ST STE 202
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City | TACOMA
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State | WA
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Zip | 98405-1462
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Country | US
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Telephone | 253-565-3355
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Fax | 253-564-6744
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Provider Business Mailing Address
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Address Line | 4050 SO 19TH STREET SUITE 202 MS: 737-2-PHYS
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-565-3355
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Fax | 253-564-6744
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO00000249
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO00000249
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License Number State | WA
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