Provider Demographics
NPI:1821196858
Name:GASPAR, PATRICK S (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:S
Last Name:GASPAR
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:PO BOX 37090
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3090
Mailing Address - Country:US
Mailing Address - Phone:703-295-9360
Mailing Address - Fax:703-295-9369
Practice Address - Street 1:2501 PARKERS LN
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3209
Practice Address - Country:US
Practice Address - Phone:703-664-7049
Practice Address - Fax:703-295-9369
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033785207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA295565OtherAMERIGROUP
VAP00220018OtherRAILROAD MEDICARE
VA187844OtherPHCS
VA136756OtherANTHEM
VA1821196858Medicaid
VAK142-0001OtherCARE FIRST
VA126716OtherKAISER
VA484645OtherNCPPO
DC014332F89Medicare ID - Type Unspecified
VAK142-0001OtherCARE FIRST
VAP00220018OtherRAILROAD MEDICARE