MEDICARE: ROBERT S EMERICK 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
1	207RC0000X	Cardiovascular Disease Physician	MD00040562	WA
2	207RI0011X	Interventional Cardiology Physician	MD212735	OR
3	207RI0011X	Interventional Cardiology Physician	49027	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1255315495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT S EMERICK MD

Provider Business Mailing Address
First Line	:	4423 POINT FOSDICK DR NW
Second Line	:	SUITE 300
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-1797
Country	:	US
Telephone Number	:	253-432-4466
Fax Number	:	253-432-4468

Provider Business Practice Location Address
First Line	:	4423 POINT FOSDICK DR NW
Second Line	:	SUITE 300
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-1797
Country	:	US
Telephone Number	:	253-432-4466
Fax Number	:	253-432-4468

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	10/04/2022

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Directions to “ ROBERT S EMERICK MD” Practice Location

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