Provider Demographics
NPI:1235124793
Name:FINNERTY, ROBERT U (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:U
Last Name:FINNERTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1708 YAKIMA AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5307
Mailing Address - Country:US
Mailing Address - Phone:253-272-8822
Mailing Address - Fax:253-272-8855
Practice Address - Street 1:1802 YAKIMA AVE
Practice Address - Street 2:STE 205
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4499
Practice Address - Country:US
Practice Address - Phone:253-272-8822
Practice Address - Fax:253-272-8855
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA19475208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB35312Medicare ID - Type Unspecified
WAA08402Medicare UPIN