Healthcare Provider Details

I. General information

NPI: 1902854557
Provider Name (Legal Business Name): DAPHNE THOMAS KASPEREK MD, FACEP, FMCP-M
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47763 BLOCKHOUSE POINT PL
STERLING VA
20165-7472
US

IV. Provider business mailing address

47763 BLOCKHOUSE POINT PL
STERLING VA
20165-7472
US

V. Phone/Fax

Practice location:
  • Phone: 202-957-8454
  • Fax:
Mailing address:
  • Phone: 202-957-8454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101054807
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number0101054807
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: