Provider Demographics
NPI:1619742376
Name:KOSIE-WILLIAMS, ROBERT HAROLD
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:HAROLD
Last Name:KOSIE-WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6008 BECKENHAM WAY
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-9605
Mailing Address - Country:US
Mailing Address - Phone:336-340-9957
Mailing Address - Fax:
Practice Address - Street 1:907 DILLARD ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-3022
Practice Address - Country:US
Practice Address - Phone:336-340-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home