Provider Demographics
NPI:1609204403
Name:UERKVITZ, RYAN (PA)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:UERKVITZ
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 1:2940 E BANNER GATEWAY DRIVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2165
Mailing Address - Country:US
Mailing Address - Phone:480-256-6444
Mailing Address - Fax:480-256-4734
Practice Address - Street 1:2940 E BANNER GATEWAY DRIVE
Practice Address - Street 2:SUITE 450
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2165
Practice Address - Country:US
Practice Address - Phone:480-256-6444
Practice Address - Fax:480-256-4734
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-15
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5485363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical