Individual
DR. CHARLEY B GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1104 COMMONS AVE, CORTLAND, NY 13045-1643
(607) 758-3750
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25541
NE
207X00000X
Orthopaedic Surgery Physician
258183
NY
207X00000X
Orthopaedic Surgery Physician
Primary
MD436074
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025863500
—
NE
01
—
34682
BLUECROSS BLUESHIELD
NE
01
—
MD436074
MD LICENSE
PA
01
—
P00840049
RAILROAD MEDICARE
—
Enumeration date
06/05/2007
Last updated
06/13/2022
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