MEDICARE: DR. STANLEY A GERING M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	7836	AZ

General Provider Information

NPI Number	:	1154324051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY A GERING M.D.

Provider Business Mailing Address
First Line	:	4545 E CHANDLER BLVD
Second Line	:	STE 204
City	:	PHOENIX
State	:	AZ
Zip	:	85048-7646
Country	:	US
Telephone Number	:	480-893-2100
Fax Number	:	480-893-2441

Provider Business Practice Location Address
First Line	:	4545 E CHANDLER BLVD
Second Line	:	STE 204
City	:	PHOENIX
State	:	AZ
Zip	:	85048-7646
Country	:	US
Telephone Number	:	480-893-2100
Fax Number	:	480-893-2441

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	05/16/2013

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