MARK ALAN GELLASCH PHYSICIAN ASSISTANT NPI 1902876931

NPI Information

NPI: 1902876931
Provider Name: MARK ALAN GELLASCH, PHYSICIAN ASSISTANT
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
BRANCH MEDICAL CLINIC NORFOLK
1721 TAUSSIG BLVD
NORFOLK, VA
ZIP 23511
Phone: (757) 314-6377
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Mark Alan Gellasch, PHYSICIAN ASSISTANT is a medical physician assistant in Norfolk, VA. Mark Alan Gellasch, PHYSICIAN ASSISTANT NPI is 1902876931. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

BRANCH MEDICAL CLINIC NORFOLK
1721 TAUSSIG BLVD
NORFOLK, VA
ZIP 23511
Phone: (757) 314-6377

The enumeration date for this NPI number is 1/24/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	0110000034	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1003448	OTHER		NATIONAL CERTIFICATION
2	0110000034	OTHER	VIRGINIA	STATE MEDICAL LICENCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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