Healthcare Provider Details

I. General information

NPI: 1952486029
Provider Name (Legal Business Name): ROBERT CARR MOFFATT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 VICTORIA RD
ASHEVILLE NC
28801-4449
US

IV. Provider business mailing address

86 VICTORIA RD
ASHEVILLE NC
28801-4449
US

V. Phone/Fax

Practice location:
  • Phone: 828-258-2464
  • Fax: 828-255-8224
Mailing address:
  • Phone: 828-258-2464
  • Fax: 828-255-8224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number14543
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: