| Doctor Name: | DEREK SCOTT GASPER |
| NPI Number: | 1770748717 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O |
| License Number: | 125054141 |
| Business Practice Address: | 1101 Glendale Blvd Suite 103 Valparaiso, IN - 463833767 |
| Business Phone Number: | 2194649521 |
| Business Fax Number: | 2194651442 |
| Mailing Address: | 1101 Glendale Blvd, Suite 103 VALPARAISO |
| State: | IN |
| Postal Code: | 463833767 |
| Phone Number: | 2194649521 |
| Fax Number: | 2194651442 |
| NPI Enumeration Date: | 07/18/2008 |
| NPI Last Update Date: | 01/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 125054141 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |