Basic Information
| Provider Information | |||||||||
| NPI: | 1821196858 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GASPAR | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 37090 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212973090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032959360 | ||||||||
| FaxNumber: | 7032959369 | ||||||||
| Practice Location | |||||||||
| Address1: | 2501 PARKERS LN | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 223063209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7036647049 | ||||||||
| FaxNumber: | 7032959369 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 08/26/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 0101033785 | VA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 295565 | 01 | VA | AMERIGROUP | OTHER | P00220018 | 01 | VA | RAILROAD MEDICARE | OTHER | 187844 | 01 | VA | PHCS | OTHER | 136756 | 01 | VA | ANTHEM | OTHER | 1821196858 | 05 | VA | MEDICAID | K142-0001 | 01 | VA | CARE FIRST | OTHER | 126716 | 01 | VA | KAISER | OTHER | 484645 | 01 | VA | NCPPO | OTHER |