MARK ALAN GELLASCH (NPI# 1902876931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902876931 |
| Entity Type | Individual |
| Full Name | MARK ALAN GELLASCH |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
Branch Medical Clinic Norfolk 1721 Taussig Blvd Norfolk VA 23511 |
| Mailing Address |
2753 Sandpiper Rd Virginia Beach VA 23456-4516 |
| Practice Telephone | 7573146377 |
| Mailing Telephone | 7574267700 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110000034 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NATIONAL CERTIFICATION | 1003448 | 01 | |
| VA | STATE MEDICAL LICENCE | 0110000034 | 01 |
| Street Address |
BRANCH MEDICAL CLINIC NORFOLK 1721 TAUSSIG BLVD |
| City | NORFOLK |
| State | VA |
| Zip Code | 23511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215591888 | Nash Richard Galvan | Military Health Care Provider | 456-462 Pocahontas St, Norfolk, VA 23511 | 2019-04-29 |
| 1578059481 | Hillary Anne Diffee | Dentist | Navsta Norfolk Sewells Point Branch Clinic, 1647 Admiral Taussig Blvd, Norfolk, VA 23511 | 2018-07-03 |
| 1154860237 | Alexander Blau | General Practice | 1751 Morris Street, Comnavsurflant - Medical Readiness Division, Norfolk, VA 23511 | 2017-02-22 |
| 1205188307 | Agnes Bautista Banias | Dental Hygienist | 1647 Admiral Taussig Blvd Br Health Clinic, Naval Medical Center Portsmouth, Norfolk, VA 23511 | 2012-10-12 |
| 1891052676 | Conor Francis Hynes | Surgery | 1530 Gilbert St Ste 2000, Norfolk, VA 23511 | 2012-04-18 |
| 1871867747 | Brian Joseph Kennerley | Surgery | U. S. Marine Corps Forces Command, 1775 Forrestal Drive Bldg 33, Norfolk, VA 23511 | 2012-02-23 |
| 1053629964 | Shawnly Heath Ward | Military Health Care Provider | Surface Warfare Medical Institute - East, 459 Bellinger Blvd, Norfolk, VA 23511 | 2010-09-14 |
| 1225351760 | Jocelyn Martinezdelgado | Military Health Care Provider | 8857 1st Street, Pcu Jason Dunham Suite 400, Norfolk, VA 23511 | 2010-03-11 |
| 1245480854 | Vanessa O Hofilena | Dentist | 1647 Admiral Taussig Boulevard, Naval Medical Center Portsmouth - Dental Center, Norfolk, VA 23511 | 2008-09-19 |
| 1780833954 | Cecilia M Brownblake | Dentist | 1647 Admiral Taussig Blvd., Norfolk, VA 23511 | 2008-09-12 |
| Find all providers in zip 23511 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
| 1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
| 1205345584 | Cassandra Lee Elverum | Physician Assistant | 600 Childrens Ln, Norfolk, VA 23507 | 2017-09-29 |
| 1790904456 | Thomas George Parish | Physician Assistant | 700 W Olney Rd, Norfolk, VA 23507-1607 | 2007-04-24 |
| 1649345372 | Ronald E Nave | Physician Assistant | 814 Kempsville Rd Ste 104, Norfolk, VA 23502-4001 | 2006-11-21 |
| 1073581823 | Karen Hintz Charlton | Physician Assistant | 1035 Nidar Blvd, Norfolk, VA 23521 | 2006-03-09 |
| 1073132551 | Ashley Makie | Physician Assistant | 3 Cedar St, Norfolk, MA 02056-1566 | 2020-04-14 |
| 1376179465 | Emily J Laughlin | Physician Assistant | 6379 Center Dr, Norfolk, VA 23502-4102 | 2020-03-20 |
| 1629604095 | Erin Anne Gray | Physician Assistant | 100 Kingsley Ln Ste 400, Norfolk, VA 23505-4604 | 2020-03-18 |
| 1881226330 | Gabrielle Gauthier | Physician Assistant | 6379 Center Dr, Norfolk, VA 23502-4102 | 2020-02-12 |
| Find all providers in NORFOLK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.