DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1891803599

NPI Code Detail

MEDICARE: ANDREA GAULT DO

MEDICARE: ANDREA GAULT DO

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	207P00000X	Emergency Medicine Physician	65060	WI
2	207P00000X	Emergency Medicine Physician	2180	WV
3	207Q00000X	Family Medicine Physician	D36761	MD
4	207Q00000X	Family Medicine Physician	2180	WV
5	207Q00000X	Family Medicine Physician	H0060072	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00875673	OTHER	MD	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1923578	OTHER	MD	AETNA CAPITATED
2	7387630	OTHER	MD	AETNA- FEE FOR SERVICE
3	2717215	OTHER	MD	UNITED HEALTHCARE
4	8200372	OTHER	MD	MAMSI- PRIMARY CARE
6	2200372	OTHER	MD	MAMSI- SPECIALIST
7	7605-0099	OTHER	MD	CAREFIRST
8	893418-05	OTHER	MD	CAREFIRST MD RENDERING
9	224132	OTHER	MD	JHHC- PROVIDER NUMBER
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	7605-0099	OTHER	MD	BLUE CHOICE
12	P18266	OTHER	MD	CAREFIRST MPOS

General Provider Information

NPI Number	:	1891803599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA GAULT DO

Provider Business Mailing Address
First Line	:	5000 COX RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-9263
Country	:	US
Telephone Number	:	804-968-5700
Fax Number	:	804-217-7991

Provider Business Practice Location Address
First Line	:	2051 WEST ST
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-3006
Country	:	US
Telephone Number	:	443-603-0758
Fax Number	:

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	03/21/2019

Similar Medicare Providers

1851391296 — DR. ROBERT WILLIAM DESVERREAUX M.D.,PH.D.
Practice Location Address:

2051 WEST ST
ANNAPOLIS, MD
21401-3006

Practice Phone: 443-603-0758
Practice Fax: 443-603-0759

1235130121 — DR. PATRICIA ANN BOWYER M.D.
Practice Location Address:

2051 WEST ST
ANNAPOLIS, MD
21401-3006

Practice Phone: 443-603-0758
Practice Fax:

1730411802 — KERRIE MICHELLE PARAS PA-C
Practice Location Address:

2051 WEST ST
ANNAPOLIS, MD
21401-3006

Practice Phone: 443-603-0758
Practice Fax:

1457640526 — MARK E. MORGAN DO
Practice Location Address:

2051 WEST ST
ANNAPOLIS, MD
21401-3006

Practice Phone: 443-603-0758
Practice Fax:

1265770259 — MRS. HEATHER LYNN COLLISON P.A.-C
Practice Location Address:

2051 WEST ST
ANNAPOLIS, MD
21401-3006

Practice Phone: 443-603-0758
Practice Fax:

1134587371 — PATIENT CARE PHARMACY INC
Practice Location Address:

2047 WEST ST , SUITE A
ANNAPOLIS, MD
21401-3006

Practice Phone: 443-949-9005
Practice Fax: 443-949-9152

Directions to “ ANDREA GAULT DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.