Provider Demographics
NPI:1891708822
Name:GOSSETT, ROBERT PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PETER
Last Name:GOSSETT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9735 KINCEY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9118
Mailing Address - Country:US
Mailing Address - Phone:704-414-2870
Mailing Address - Fax:704-414-2860
Practice Address - Street 1:1001 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-1800
Practice Address - Country:US
Practice Address - Phone:704-482-2011
Practice Address - Fax:704-484-0303
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2021-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC24070208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC340013358OtherRR MEDICARE
NC24070OtherNC MEDICAL LICENSE #
NC230126OtherMEDICARE PTAN
NC340013358OtherRR MEDICARE
NCC84129Medicare UPIN