Provider Demographics
NPI:1710960323
Name:GESSERT, CAROLINE M (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:GESSERT
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 1:610 SOLAREX CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-8624
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:610 9TH AVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:MD
Practice Address - Zip Code:21716-1828
Practice Address - Country:US
Practice Address - Phone:301-834-7188
Practice Address - Fax:301-834-7889
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056890207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM51764OtherCDS
MDM51764OtherCDS
MDCD8143Medicare PIN
MDM51764OtherCDS
MDA656Medicare PIN
MD451LMedicare PIN
MDP00073734Medicare PIN