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Individual

ROBERT P GATEWOOD JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
425 ESSJAY RD, BUFFALO MEDICAL GROUP, PC, WILLIAMSVILLE, NY 14221-5782
(716) 630-1146
(716) 817-1729
Mailing address
6255 SHERIDAN DR, SUITE 108 - CREDENTIALING DEPT, WILLIAMSVILLE, NY 14221-4836
(716) 630-1219
(716) 817-1726

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
124062
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010060701
UNIVERA
NY
01
000508569001
BLUE CROSS COMMUNITY BLUE
01
2100905
INDEPENDENT HEALTH
05
660068
NY
Enumeration date
01/05/2006
Last updated
05/20/2016
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