Individual
ROBERT P GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
15571 N. REEMS RD, SURPRIZE, AZ 85374
(623) 544-6932
(623) 321-1070
Mailing address
15571 N. REEMS RD, SURPRIZE, AZ 85374
(623) 544-6932
(623) 321-1070
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2036
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
642026
—
AZ
Enumeration date
09/19/2005
Last updated
07/08/2013
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