MEDICARE: SANDRA O. GASAWAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1063347540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA O. GASAWAY

Provider Business Mailing Address
First Line	:	8700 OAKDALE ST
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-1811
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8700 OAKDALE ST
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-1811
Country	:	US
Telephone Number	:	301-653-3592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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Directions to “ SANDRA O. GASAWAY ” Practice Location

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