Organization
GATEWAY ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT S BASHORE (ADMINISTRATOR)
(704) 779-6861
Entity
Organization
Contact information
Practice address
1025 NE GATEWAY CT, CONCORD, NC 28025-2440
(704) 920-7020
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
NC
Other
Enumeration date
03/18/2009
Last updated
01/23/2013
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