Robert Bruce Baucke, MD

Individual provider Active NPI Internal Medicine Physician · Kent, WA

NPI 1720007164 · NPPES record last updated Feb 18, 2010

Key facts

NPI
1720007164
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
MD00022872 (WA)
Practice address
222 State Ave N
Kent, WA 98030-4544
Phone
(253) 372-7866
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC Past Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00022872 WA Yes

Addresses

Primary practice location

222 State Ave N
Kent, WA 98030-4544

Mailing address

PO Box 5299
Tacoma, WA 98415-0299

Other providers in Kent, WA

All providers in Kent, WA · Internal Medicine Physician in Washington

Sources for this page

Verify at the official NPI Registry.