Individual
ROBERT C WALDRIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12361 W BOLA DR, SUITE 100, SURPRISE, AZ 85378-9021
(623) 584-5626
(623) 544-9122
Mailing address
12361 W BOLA DR, STE 100, SURPRISE, AZ 85378-9021
(623) 584-5626
(623) 544-9122
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
13525
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912990094
AHCCCS
AZ
01
—
1912990994
BC/BS AZ OUT OF AREA
—
01
—
200006477
RAILROAD MEDICARE
—
01
—
256083
AHCCCS
—
05
—
256083
—
AZ
01
—
2Z3248
HEALTH NET
AZ
01
—
5124334
AETNA
AZ
01
—
730511
UNITED HEALTHCARE
AZ
01
—
AZ0334260
BCBS BLUECARD PROGRAM
AZ
Enumeration date
08/24/2005
Last updated
10/12/2011
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