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Individual

ROBERT R WITHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3920 CAPITAL MALL DR SW, SUITE 100, OLYMPIA, WA 98502-8701
(360) 753-4700
(360) 753-6700
Mailing address
3920 CAPITAL MALL DR SW, SUITE 100, OLYMPIA, WA 98502-8701
(360) 753-4700
(360) 753-6700

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00017298
WA
207RG0100X
Gastroenterology Physician
MD00017298
WA
207RH0003X
Hematology & Oncology Physician
MD00017298
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1506807
WA
Enumeration date
07/13/2006
Last updated
10/15/2010
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