Individual
DEREK SCOTT GASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1101 GLENDALE BLVD STE 102A, VALPARAISO, IN 46383-3767
(219) 464-9521
(219) 465-1442
Mailing address
1101 GLENDALE BLVD, SUITE 103, VALPARAISO, IN 46383-3767
(219) 464-9521
(219) 465-1442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003800A
IN
207Q00000X
Family Medicine Physician
36.126288
IL
390200000X
Student in an Organized Health Care Education/Training Program
125054141
IL
Other
Enumeration date
07/18/2008
Last updated
09/10/2020
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