Provider Demographics
NPI:1477972651
Name:VERCIO, ROBERT C (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:VERCIO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7308 BRIDGEPORT WAY W STE 201
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8000
Mailing Address - Country:US
Mailing Address - Phone:253-582-7257
Mailing Address - Fax:253-582-1617
Practice Address - Street 1:2727 HOLLYCROFT ST STE 410
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1369
Practice Address - Country:US
Practice Address - Phone:253-358-4002
Practice Address - Fax:253-358-4015
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2021-08-17
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Provider Licenses
StateLicense IDTaxonomies
WAMD61152639207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2179955Medicaid