Provider Demographics
NPI:1205874955
Name:KANTER, ROBERT A (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:KANTER
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 1:2611 NE 125TH ST #90
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4357
Mailing Address - Country:US
Mailing Address - Phone:206-362-0035
Mailing Address - Fax:206-362-6927
Practice Address - Street 1:2611 NE 125TH ST
Practice Address - Street 2:SUITE 90
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4373
Practice Address - Country:US
Practice Address - Phone:206-362-0035
Practice Address - Fax:206-362-6927
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00014960174400000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1507300Medicaid
WA460001130OtherRR MEDICARE
WA460001130OtherRR MEDICARE
WAG8856443Medicare PIN