Healthcare Provider Details

I. General information

NPI: 1316994635
Provider Name (Legal Business Name): ROBERT JOSEPH DASNOIT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2718 HENRY ST
GREENSBORO NC
27405-3633
US

IV. Provider business mailing address

PO BOX 602658
CHARLOTTE NC
28260-2658
US

V. Phone/Fax

Practice location:
  • Phone: 336-375-1007
  • Fax: 336-375-9615
Mailing address:
  • Phone: 336-716-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number100790
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: