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Individual

ROBERT S MECKLENBURG

Active
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Individual

ROBERT S MECKLENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD00013236
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039579
LABOR & INDUSTRY
WA
05
—
8265902
—
WA
01
—
M475
BLUE SHIELD
WA
01
—
US0818836
AETNA/USHC PCP
WA
01
—
US0899738
AETNA/USHC SPECIALIST
WA
Enumeration date
08/04/2006
Last updated
04/07/2008
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