MEDICARE: GASTON DERMATOLOGY CLINIC P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	39982	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710961263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTON DERMATOLOGY CLINIC P.A.

Provider Business Mailing Address
First Line	:	1072 X RAY DR
Second Line	:	P.O. BOX 3598
City	:	GASTONIA
State	:	NC
Zip	:	28054-7488
Country	:	US
Telephone Number	:	704-864-8386
Fax Number	:	704-864-3361

Provider Business Practice Location Address
First Line	:	1072 X RAY DR
Second Line	:	SUITE A
City	:	GASTONIA
State	:	NC
Zip	:	28054-7488
Country	:	US
Telephone Number	:	704-864-8386
Fax Number	:	704-864-3361

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT HOWARD KAHN
Credential	:	M.D.
Telephone Number	:	704-864-8386

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1154376028 — EMERALD CARE LLC
Practice Location Address:

1050 XRAY DRIVE
GASTONIA, NC
28054-7488

Practice Phone: 704-867-1141
Practice Fax: 704-864-3673

1225037195 — DR. EDWARD J SILVOY M.D.
Practice Location Address:

1010 X RAY DR , SUITE A
GASTONIA, NC
28054-7488

Practice Phone: 704-865-7677
Practice Fax: 704-865-0756

1982691663 — DR. ANOOP KUMAR KALIA M.D.
Practice Location Address:

1054 X RAY DR
GASTONIA, NC
28054-7488

Practice Phone: 704-853-0054
Practice Fax: 704-853-0075

1326013905 — DR. JAMES E NEAL M.D.
Practice Location Address:

1072 X RAY DR , SUITE B
GASTONIA, NC
28054-7488

Practice Phone: 704-864-0315
Practice Fax: 704-864-8994

1801832837 — PIEDMONT PLASTIC SURGERY & DERMATOLOGY PA
Practice Location Address:

1072 X RAY DR STE B
GASTONIA, NC
28054-7488

Practice Phone: 704-671-1094
Practice Fax:

1033120290 — DR. DAVID R GUILLEN M.D.
Practice Location Address:

1072 X RAY DR
GASTONIA, NC
28054-7488

Practice Phone: 704-671-1094
Practice Fax:

Directions to “GASTON DERMATOLOGY CLINIC P.A. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.