Provider Demographics
NPI:1740600758
Name:SERTICH, ANTHONY PATRICK III (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:PATRICK
Last Name:SERTICH
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:SERTICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:UNIVERSITY OF WASHINGTON
Mailing Address - Street 2:BOX 356410
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:206-543-3654
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF WASHINGTON
Practice Address - Street 2:BOX 356410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-543-3654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program