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Dr. Maxine Victoria Gerken
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Maxine Victoria Gerken |
| Gender: | F |
| Provider License Number If Given: | G64845 |
NPI Information:
| NPI: | 1518966035 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 6/30/2015 |
Provider Business Mailing Address:
| Address: | 4212 N 16TH ST INTEGRATED SURGICAL SERVICE Phoenix, AZ 85016 |
| Phone Number: | 6022631200 |
| Fax Number: | 6022005366 |
Provider Business Practice Location Address:
| Address: | 4212 N 16TH ST INTEGRATED SURGICAL SERVICE Phoenix, AZ 85016 |
| Phone Number: | 6022631200 |
| Fax Number: | 6022005366 |
Provider Taxonomy:
| Primary: | 208600000X |
| Secondary (if any): | |
| State: | AZ |
