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Export Provider Record NPI 1083623979
Larry H GastonM.D.
Active
NPI Number1083623979
NPI TypeNPI-1 Individual
SpecialtyDermatology
Provider Details
NPI1083623979
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2006-08-07
Last Updated2021-09-09
Mailing Address2300 Garrison Blvd, Suite 260
Baltimore, MD 21216-2335
United States
Phone: (410) 945-7544 | Fax: (410) 945-3605
📍 View Map
Primary Practice Address2300 Garrison Blvd, Suite 260
Baltimore, MD 21216-2335
United States
Phone: (410) 945-7544 | Fax: (410) 945-3605
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDMD331621100
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207N00000X – DermatologyMDD29768
Export Provider Record NPI 1083623979
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About NPI 1083623979

Larry H Gaston M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1083623979. The primary specialty listed is Dermatology. The provider is located in Baltimore, MD. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-08-07. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1083623979?

NPI 1083623979 belongs to Larry H Gaston M.D., a Dermatology in Baltimore, MD. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1083623979 active?

The current status of NPI 1083623979 in the NPPES registry is Active. The record was last updated on 2021-09-09.

What specialty is NPI 1083623979?

NPI 1083623979 is classified under the taxonomy Dermatology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1083623979?

You can verify NPI 1083623979 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1083623979?

The primary practice address on file for NPI 1083623979 is 2300 Garrison Blvd, Baltimore, MD 21216-2335. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1083623979 issued?

NPI 1083623979 was first issued (enumerated) on 2006-08-07. The NPPES record was last updated on 2021-09-09.

Practice Location Map

Larry H Gaston is located at 2300 Garrison Blvd, Baltimore, MD. Use the map below to find directions or verify the practice location.

📍 2300 Garrison Blvd, Baltimore, MD 21216-2335  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Larry H Gaston. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1083623979. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
DermatologyD29768MD
Data Verified from CMS NPPES Last synced: 2026-06-21 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162