Basic Information
Provider Information
NPI: 1881694891
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAVAGE
FirstName: ROBERT
MiddleName: T
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 320 SANTA FE DR
Address2: SUITE 308
City: ENCINITAS
State: CA
PostalCode: 920245138
CountryCode: US
TelephoneNumber: 7606324269
FaxNumber: 7606324256
Practice Location
Address1: 320 SANTA FE DR
Address2: SUITE 308
City: ENCINITAS
State: CA
PostalCode: 920245138
CountryCode: US
TelephoneNumber: 7606324269
FaxNumber: 7606324256
Other Information
ProviderEnumerationDate: 08/01/2005
LastUpdateDate: 09/21/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XG27715CAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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