Individual
DR. CHARLES BEVERLY LYTLE GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5452
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5452
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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