Provider Demographics
NPI:1104871607
Name:HOERTZ, MARIA (DO,MPH)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:HOERTZ
Suffix:
Gender:F
Credentials:DO,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20987 N JOHN WAYNE PKWY
Mailing Address - Street 2:B104 209
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-2926
Mailing Address - Country:US
Mailing Address - Phone:561-699-4488
Mailing Address - Fax:
Practice Address - Street 1:20987 N JOHN WAYNE PKWY
Practice Address - Street 2:B104 209
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-2926
Practice Address - Country:US
Practice Address - Phone:561-699-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44201207Q00000X
MN65756207QG0300X
AZ4765207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSH62774Medicare UPIN
MSH62774Medicare UPIN