Provider Demographics
NPI:1245232602
Name:KASPER, GREGORY C (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:C
Last Name:KASPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 HUGHES DR STE 450
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-5102
Mailing Address - Country:US
Mailing Address - Phone:419-291-2003
Mailing Address - Fax:419-251-3419
Practice Address - Street 1:2109 HUGHES DR STE 450
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-291-2003
Practice Address - Fax:419-479-6977
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-2613-K2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4289285Medicaid
OH03988OtherPARAMOUNT
OH2551503Medicaid
GA770002666Medicare UPIN
MI4289285Medicaid
OH2551503Medicaid
MIN98710001Medicare UPIN