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NPI Code Detail

MEDICARE: DR. ROBERT L GAZDECK OD

MEDICARE: DR. ROBERT L GAZDECK OD
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
1152W00000XOptometrist0978NC

Other Identifiers

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

General Provider Information

NPI Number : 1811069859
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT L GAZDECK OD
Provider Business Mailing Address
First Line : 212 MOCKINGBIRD LN
Second Line :
City : LINCOLNTON
State : NC
Zip : 28092-3259
Country : US
Telephone Number : 704-392-7699
Fax Number : 704-392-1716
Provider Business Practice Location Address
First Line : 3240 WILKINSON BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-5630
Country : US
Telephone Number : 704-392-7699
Fax Number : 704-392-1716
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 05/14/2008

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Directions to “ DR. ROBERT L GAZDECK OD” Practice Location

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