Gakuba, Chrysologue
Gakuba, Chrysologue is an sole proprietor health care provider with primary practice located at 2 Reservoir Cir Suite 105, Pikesville MD 21208-6393. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Gakuba, Chrysologue can be contacted via phone (410) 653-1822.Contact Information
Primary practice address
2 Reservoir Cir Suite 105
Pikesville MD 21208-6393
Phone: (410) 653-1822
Fax: (410) 653-1857
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | D15533 | Maryland |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | D15533 | Maryland |
Profile Details
| NPI number | 1619069846 |
|---|---|
| LBN Legal business name | Gakuba, Chrysologue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Nov 28th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619069846 | NPPES |
| Maryland | Other | 60061888 | R/R MEDICARE PROVIDER # |
| Maryland | MEDICAID | 030281300 | R/R MEDICARE PROVIDER # |
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