Provider Demographics
NPI:1497588420
Name:VAN MAREN, GRETCHEN A (MD)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:A
Last Name:VAN MAREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:A
Other - Last Name:MAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2708 E VIA ROTUNDA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-5227
Mailing Address - Country:US
Mailing Address - Phone:520-730-6359
Mailing Address - Fax:
Practice Address - Street 1:7225 N MONA LISA RD STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-4528
Practice Address - Country:US
Practice Address - Phone:520-547-7000
Practice Address - Fax:520-547-7002
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21135207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine