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Individual

ENRICO D GASPAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2986 US HIGHWAY 431, BOAZ, AL 35957-5848
(256) 840-8181
(256) 744-7290
Mailing address
PO BOX 697, BOAZ, AL 35957-0697
(256) 840-8181
(256) 744-7290

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00026230
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
169927
AL
01
511-54768
BLUE CROSS BLUE SHIELD
AL
Enumeration date
09/15/2005
Last updated
04/09/2022
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