Provider Demographics
NPI:1902985237
Name:GATES, ROBERT NEVILL (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:NEVILL
Last Name:GATES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NEVILL
Other - Middle Name:
Other - Last Name:GATES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 14883
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-4883
Mailing Address - Country:US
Mailing Address - Phone:336-274-3241
Mailing Address - Fax:336-272-7134
Practice Address - Street 1:301 E WENDOVER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1230
Practice Address - Country:US
Practice Address - Phone:336-274-3241
Practice Address - Fax:336-272-7134
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC34953OtherBCBS OF NC
NC8934953Medicaid
NC53740OtherMEDCOST
NC5574OtherPARTNERS MEDICARE
NC5574OtherPARTNERS MEDICARE
NC8934953Medicaid
NC34953OtherBCBS OF NC