Provider Demographics
NPI:1316992381
Name:GREGASAVITCH, GARY F (DPM)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:F
Last Name:GREGASAVITCH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7001 HERITAGE VILLAGE PLZ STE 230
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3095
Mailing Address - Country:US
Mailing Address - Phone:703-858-3211
Mailing Address - Fax:888-246-3989
Practice Address - Street 1:7001 HERITAGE VILLAGE PLZ STE 230
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3095
Practice Address - Country:US
Practice Address - Phone:703-273-9332
Practice Address - Fax:888-246-3989
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300881213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU95761Medicare UPIN