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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

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