Provider Demographics
NPI:1023071966
Name:HUCK, ROBERT LOVE (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LOVE
Last Name:HUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:500 LILLY RD NE SUITE 201
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98503-5197
Mailing Address - Country:US
Mailing Address - Phone:360-413-8272
Mailing Address - Fax:360-413-8878
Practice Address - Street 1:500 LILLY RD NE SUITE 201
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98503-5197
Practice Address - Country:US
Practice Address - Phone:360-413-8272
Practice Address - Fax:360-413-8878
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00020678207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8479800Medicaid
WA8479800Medicaid
WAA55209Medicare UPIN