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NPI Code Detail

MEDICARE: DR. ROBERT PAUL GERVAIS M.D.

MEDICARE:  DR. ROBERT PAUL GERVAIS  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
1207W00000XOphthalmology Physician8919AZ

General Provider Information

NPI Number : 1376724955
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT PAUL GERVAIS M.D.
Provider Business Mailing Address
First Line : PO BOX 31270
Second Line :
City : MESA
State : AZ
Zip : 85275-1270
Country : US
Telephone Number : 602-568-8039
Fax Number : 480-835-7844
Provider Business Practice Location Address
First Line : 1530 W GLENDALE AVE
Second Line : SUITE 103
City : PHOENIX
State : AZ
Zip : 85021-8578
Country : US
Telephone Number : 602-995-2000
Fax Number : 602-995-8408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2007
Last Update Date : 04/24/2008

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Directions to “ DR. ROBERT PAUL GERVAIS M.D.” Practice Location

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