# ROBERT S MECKLENBURG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1447268545
- **Gender:** Man
- **Credential:** MD

## Taxonomy

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

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 04/07/2008

## 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 |