Individual
ROBERT HERDMAN SUDDUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 NW MYHRE RD, SILVERDALE, WA 98383-7681
(360) 830-1205
(360) 830-1281
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00025993
WA
207RG0100X
Gastroenterology Physician
Primary
MD00025993
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110162832
RAILROAD MEDICARE
—
01
—
117877
LABOR & INDUSTRIES
WA
01
—
5440589
AETNA
—
05
—
8214132
—
WA
01
—
SU0778
REGENCE BLUESHIELD
—
Enumeration date
06/26/2006
Last updated
03/07/2023
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