Provider Demographics
NPI:1336274760
Name:GAY, ROBERT M (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:GAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4388 FEDERAL DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8115
Mailing Address - Country:US
Mailing Address - Phone:336-315-6100
Mailing Address - Fax:
Practice Address - Street 1:4388 FEDERAL DR
Practice Address - Street 2:SUITE 120
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8115
Practice Address - Country:US
Practice Address - Phone:336-315-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17628246Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN39337OtherSTATE MEDICAL LICENSE
NC17628OtherSTATE MEDICAL LICENSE
NC17628OtherSTATE MEDICAL LICENSE