Provider Demographics
NPI:1518159888
Name:PATRICIA G GAO MD LLC
Entity Type:Organization
Organization Name:PATRICIA G GAO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:GEIGER
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-760-7333
Mailing Address - Street 1:P.O.BOX 11545
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4006
Mailing Address - Country:US
Mailing Address - Phone:410-760-7333
Mailing Address - Fax:410-766-3838
Practice Address - Street 1:203 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-6437
Practice Address - Country:US
Practice Address - Phone:410-760-7333
Practice Address - Fax:410-766-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD994AOtherBC/BS OF MD
MD016004100Medicaid
MDJ901OtherBC/BS FEP
MDJ901OtherBC/BS FEP
MD016004100Medicaid