Provider Demographics
NPI:1558329854
Name:KASPAREK, DORIGEN K (MD)
Entity Type:Individual
Prefix:DR
First Name:DORIGEN
Middle Name:K
Last Name:KASPAREK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6335 HOSPITAL PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1549
Mailing Address - Country:US
Mailing Address - Phone:770-622-9810
Mailing Address - Fax:770-622-9811
Practice Address - Street 1:6335 HOSPITAL PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-1549
Practice Address - Country:US
Practice Address - Phone:770-622-9810
Practice Address - Fax:770-622-9811
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054445207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA360921OtherBCBS OF GEORGIA PROV #
GA7747558OtherAETNA HMO PROVIDER #
GA986553856BMedicaid
GA7747558OtherAETNA PPO PROVIDER #
GA9790810OtherCIGNA PROVIDER #
GA7747558OtherAETNA PPO PROVIDER #
GA7747558OtherAETNA HMO PROVIDER #