Physician Compare National (NPI:1598873853)

HEALTHCARE PROVIDER: ROBERT V WICK DDS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1598873853
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3577827112
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190807000907
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WICK
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	V
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1971
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ANESTHESIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	DIAGNOSTIC RADIOLOGY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 3	MAXILLOFACIAL SURGERY
	Third secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 4	PATHOLOGY
	Fourth secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ANESTHESIOLOGY, DIAGNOSTIC RADIOLOGY, MAXILLOFACIAL SURGERY, PATHOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	19682 HESPERIAN BLVD
	Group Practice or individual's line 1 address
City	HAYWARD
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	945414752
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y