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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Gary Sprouse | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | License No: D32036 | [sources] | |||
| First name | Gary | [sources] | |||
| Last name | Sprouse | [sources] | |||
| NPI | 1255443727 | [sources] | |||
| Sector | MD | [sources] | |||
| Address | 9 CHESTER PLZ, CHESTER, MD 21619-2418 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers deemed ineligible to participate in Maryland's Medicaid program.
United States of America · MDH
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