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General NPI Number Information
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NPI Number | 1679637979
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Entity Type | Individual
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Provider Name | ROBERT LEROY GATTUSO M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 106 MOUNT CARMEL RD
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City | PARKTON
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State | MD
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Zip | 21120-9723
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Country | US
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Telephone | 410-357-4500
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Fax | 410-357-4570
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Provider Business Mailing Address
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Address Line | 106 MOUNT CARMEL RD
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City | PARKTON
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State | MD
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Zip | 21120-9723
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Country | US
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Telephone | 410-357-4500
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Fax | 410-357-4570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME 70600
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | D0034622
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0034622
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License Number State | MD
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