Provider Demographics
NPI:1033170618
Name:MIDDLETON, ROBERT TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TODD
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N DIVISION ST
Mailing Address - Street 2:STE 201
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-4939
Mailing Address - Country:US
Mailing Address - Phone:253-939-1230
Mailing Address - Fax:253-735-1211
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:STE 201
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-939-1230
Practice Address - Fax:253-735-1211
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025417207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0280799OtherSTATE L&I
WA0280777OtherSTATE L&I
WA0280787OtherSTATE L&I
WA8109258Medicaid
WA8109258Medicaid
WA0280799OtherSTATE L&I
WA000109072Medicare ID - Type Unspecified