Maesaka, Gerald N

Maesaka, Gerald N is an individual health care provider with primary practice located at 601 Stadium Mall Dr , West Lafayette IN 47907-2052. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Maesaka, Gerald N can be contacted via phone (765) 494-1700.

Contact Information

Primary practice address
601 Stadium Mall Dr West Lafayette IN 47907-2052
Phone: (765) 494-1700
Fax: (765) 496-1227
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01044360 Indiana

Profile Details

NPI number 1073594784
LBN Legal business name Maesaka, Gerald N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated May 8th, 2009 - about 15 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 1073594784 NPPES
Indiana MEDICAID 200148130

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