Individual
GARY E GAWELKO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5410 W THUNDERBIRD RD, SUITE 101, GLENDALE, AZ 85306-4711
(602) 530-6189
Mailing address
5410 W THUNDERBIRD RD, SUITE 101, GLENDALE, AZ 85306-4711
(602) 530-6189
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4547
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
568261
—
AZ
Enumeration date
11/13/2009
Last updated
12/21/2010
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