Provider Demographics
NPI:1265591143
Name:RIEGER, ROBERT P (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:RIEGER
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 1:2511 M AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-3897
Mailing Address - Country:US
Mailing Address - Phone:360-293-9813
Mailing Address - Fax:360-299-8605
Practice Address - Street 1:2511 M AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-3897
Practice Address - Country:US
Practice Address - Phone:360-293-9813
Practice Address - Fax:360-299-8605
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031047207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1083948Medicaid
E90273Medicare UPIN