Provider Demographics
NPI:1043593841
Name:GERDES, MAURA BETH (DO)
Entity Type:Individual
Prefix:DR
First Name:MAURA
Middle Name:BETH
Last Name:GERDES
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:1605 S. BALTIMORE ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501
Mailing Address - Country:US
Mailing Address - Phone:660-665-3599
Mailing Address - Fax:660-665-7576
Practice Address - Street 1:1605 S. BALTIMORE ST.
Practice Address - Street 2:SUITE B
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501
Practice Address - Country:US
Practice Address - Phone:660-665-3599
Practice Address - Fax:660-665-7576
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2022-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2010018322207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine