Provider Demographics
NPI:1649453739
Name:WARWICK, ROBERT B (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:WARWICK
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 1:30809 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4074
Mailing Address - Country:US
Mailing Address - Phone:253-839-2030
Mailing Address - Fax:253-839-1071
Practice Address - Street 1:30809 1ST AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4074
Practice Address - Country:US
Practice Address - Phone:253-839-2030
Practice Address - Fax:253-839-1071
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00014587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0264294OtherSTATE L&I
WA0264298OtherSTATE L&I
WA0264305OtherSTATE L&I
WA0264301OtherSTATE L&I
WA0264295OtherSTATE L&I
WA0264297OtherSTATE L&I
WA0264304OtherSTATE L&I
WA0291699OtherSTATE L&I
WA0298551OtherSTATE L&I
WA8946021OtherSTATE CRIME VICTIMS
WA0227277OtherSTATE L&I
WA0264300OtherSTATE L&I
WA0264296OtherSTATE L&I
WA0264299OtherSTATE L&I
WA0264303OtherSTATE L&I
WA8500720Medicaid
WAG8892912Medicare PIN
WA0264294OtherSTATE L&I
WA0264297OtherSTATE L&I
WAG8869679Medicare PIN
WAG8892914Medicare PIN
WA0227277OtherSTATE L&I
WA0298551OtherSTATE L&I
WA0264304OtherSTATE L&I
WAG8892915Medicare PIN
WAG8892911Medicare PIN
WAG8892913Medicare PIN