Individual
ROBERT L WILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD00012116
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039589
LABOR & INDUSTRY
WA
01
—
390003068
RAILROAD MEDICARE
—
05
—
8269409
—
WA
01
—
MD211WA
ALASKA MEDICAID
WA
01
—
US0818851
AETNA/USHC PCP
WA
01
—
US0899920
AETNA/USHC SPECIALIST
WA
01
—
W568
BLUE SHIELD
WA
Enumeration date
08/23/2006
Last updated
10/09/2008
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