Provider Demographics
NPI:1265495170
Name:GOTSCH, PATRICIA B (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:B
Last Name:GOTSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:255 N 4TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1340
Mailing Address - Country:US
Mailing Address - Phone:301-533-1046
Mailing Address - Fax:301-533-1049
Practice Address - Street 1:255 N 4TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1340
Practice Address - Country:US
Practice Address - Phone:301-533-1046
Practice Address - Fax:301-533-1049
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045071207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE77934Medicare UPIN
PA088692Medicare PIN