Provider Demographics
NPI:1417068446
Name:HURLOW, ROBERT S (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:HURLOW
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 1:1344 WINTERGREEN LN NE UNIT 100
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-5147
Mailing Address - Country:US
Mailing Address - Phone:206-201-0488
Mailing Address - Fax:206-201-0490
Practice Address - Street 1:1344 WINTERGREEN LN NE UNIT 100
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-5147
Practice Address - Country:US
Practice Address - Phone:206-201-0488
Practice Address - Fax:206-201-0490
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1009870Medicaid
6273HUOtherREGENCE
WA225462OtherLABOR & INDUSTRIES
P00729671OtherRAILROAD MEDICARE
AETNAOther4136581
AETNAOther4136581
G8868179Medicare PIN
WA225462OtherLABOR & INDUSTRIES
6273HUOtherREGENCE
AH1973393OtherDEA
8800084Medicare ID - Type Unspecified
G8899089Medicare PIN
G8868177Medicare PIN