Gerken, Maxine Victoria

Gerken, Maxine Victoria is an individual health care provider with primary practice located at 4212 N 16Th St Integrated Surgical Service, Phoenix AZ 85016-5319. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Gerken, Maxine Victoria can be contacted via phone (602) 263-1200.

Contact Information

Primary practice address
4212 N 16Th St Integrated Surgical Service Phoenix AZ 85016-5319
Phone: (602) 263-1200
Fax: (602) 200-5366
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X G64845 California

Profile Details

NPI number 1518966035
LBN Legal business name Gerken, Maxine Victoria
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Jun 30th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518966035 NPPES
California MEDICAID 00G648450

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