Provider Demographics
NPI:1730233586
Name:SPIRO, ROBERT TIMOTHY (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TIMOTHY
Last Name:SPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16974 OLYMPIC VIEW RD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9733
Mailing Address - Country:US
Mailing Address - Phone:360-662-8924
Mailing Address - Fax:
Practice Address - Street 1:2201 S 19TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2962
Practice Address - Country:US
Practice Address - Phone:253-272-3056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00047130208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics