Individual provider · Type 1 NPI

Charles Beverly Lytle Gervais, MD

Student in an Organized Health Care Education/Training Program · Scottsdale, AZ

NPI number 1235508904 Active

Practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Call (480) 301-8000 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1235508904

Charles Beverly Lytle Gervais, MD's National Provider Identifier is 1235508904, issued on Sep 23, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Scottsdale, AZ. The record was last updated on Sep 23, 2015.