Provider Demographics
NPI:1356313068
Name:ENGH, GERARD A (MD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:A
Last Name:ENGH
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 1:2445 ARMY NAVY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2905
Mailing Address - Country:US
Mailing Address - Phone:703-769-8456
Mailing Address - Fax:703-271-9451
Practice Address - Street 1:2445 ARMY NAVY DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2905
Practice Address - Country:US
Practice Address - Phone:703-769-8456
Practice Address - Fax:703-271-9451
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101017915174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11766OtherANTHEM BCBS
VA4328729OtherAETNA PPO
VA540885758OtherTRICARE
VA25090001OtherCAREFIRST BCBS
VA737655OtherAETNA HMO
VA955229OtherUNITED HEALTHCARE ID
200029762Medicare PIN
VA955229OtherUNITED HEALTHCARE ID
VA4328729OtherAETNA PPO