Provider Demographics
NPI:1881635522
Name:GASPARI, ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:GASPARI
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 64445
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4445
Mailing Address - Country:US
Mailing Address - Phone:410-328-1058
Mailing Address - Fax:410-328-0098
Practice Address - Street 1:419 W REDWOOD ST
Practice Address - Street 2:SUITE 160
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1703
Practice Address - Country:US
Practice Address - Phone:410-328-3167
Practice Address - Fax:410-328-1323
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD37939207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCS045-0009OtherBLUE SHIELD FEDERAL
MD61004601OtherCAREFIRST BCBS OF MD
DCS045-0009OtherBLUE SHIELD FEDERAL
MDA174Medicare PIN