Provider Demographics
NPI:1952486029
Name:MOFFATT, ROBERT CARR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CARR
Last Name:MOFFATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:86 VICTORIA RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4449
Mailing Address - Country:US
Mailing Address - Phone:828-258-2464
Mailing Address - Fax:828-255-8224
Practice Address - Street 1:86 VICTORIA RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4449
Practice Address - Country:US
Practice Address - Phone:828-258-2464
Practice Address - Fax:828-255-8224
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC145432086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8959930Medicaid
NC8959930Medicaid
NCC85549Medicare UPIN