Individual
ROBERT J GAUDET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1773 ROSE RIDGE, CLINTWOOD, VA 24228
(276) 218-0032
(276) 276-9260
Mailing address
PO BOX 1980, CLINTWOOD, VA 24228-1980
(276) 218-0032
(276) 276-9260
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101036758
VA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
0101367586
VA
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
D35461
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518908169
—
VA
05
—
549841400
—
MD
05
—
5600378000
—
VA
Enumeration date
06/08/2006
Last updated
08/09/2010
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