Provider Demographics
NPI:1982797031
Name:ESPER, GARY F (DO)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:F
Last Name:ESPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 SCHAPER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-3348
Mailing Address - Country:US
Mailing Address - Phone:814-464-9145
Mailing Address - Fax:814-464-9147
Practice Address - Street 1:4002 SCHAPER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-3348
Practice Address - Country:US
Practice Address - Phone:814-464-9145
Practice Address - Fax:814-464-9147
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003984L207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008616360001Medicaid
PA0008616360001Medicaid
PAB35199Medicare UPIN