Provider Demographics
NPI:1487607362
Name:FRANCISCOVICH, ROBIN A (MD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:A
Last Name:FRANCISCOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1006
Mailing Address - Country:US
Mailing Address - Phone:360-537-5250
Mailing Address - Fax:360-532-1640
Practice Address - Street 1:915 ANDERSON DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1006
Practice Address - Country:US
Practice Address - Phone:360-532-8330
Practice Address - Fax:360-537-5244
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020283207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1003177Medicaid
WA115103102Medicare PIN
E17960Medicare UPIN