Provider Demographics
NPI:1295767457
Name:GEMAR, GARTH (MD)
Entity type:Individual
Prefix:DR
First Name:GARTH
Middle Name:
Last Name:GEMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7250 N 16TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5214
Mailing Address - Country:US
Mailing Address - Phone:630-472-8800
Mailing Address - Fax:623-208-7404
Practice Address - Street 1:7250 N 16TH ST STE 104
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5214
Practice Address - Country:US
Practice Address - Phone:630-472-8800
Practice Address - Fax:623-208-7404
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16821207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E28687Medicare UPIN
AZZ71590Medicare PIN