Provider Demographics
NPI:1093086589
Name:WEST, ROBERT SUMNER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SUMNER
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:212 W IRONWOOD DR
Mailing Address - Street 2:STE D, PMB 166
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-1403
Mailing Address - Country:US
Mailing Address - Phone:208-664-8238
Mailing Address - Fax:208-664-8238
Practice Address - Street 1:3621 W FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-9049
Practice Address - Country:US
Practice Address - Phone:208-765-0714
Practice Address - Fax:209-664-8238
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-16
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM 2875208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery