Basic Information
| Provider Information | |||||||||
| NPI: | 1033262621 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GASKILL | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 S PACA ST FL 6 | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103288025 | ||||||||
| FaxNumber: | 4103288028 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 UPPER CHESAPEAKE DR | ||||||||
| Address2: | |||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210144324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4436431000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2007 | ||||||||
| LastUpdateDate: | 08/21/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | C0003346 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.