Provider Demographics
NPI:1881226744
Name:GORZITZE-MAXEY, ADRIAN (PA)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:GORZITZE-MAXEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W COMO AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1027
Mailing Address - Country:US
Mailing Address - Phone:614-937-9896
Mailing Address - Fax:
Practice Address - Street 1:6905 HOSPITAL DR STE 130
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9600
Practice Address - Country:US
Practice Address - Phone:614-923-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-09
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006367RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant