Provider Demographics
NPI:1528325065
Name:VALLE-EGER, GABRIEL ERNESTO (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:ERNESTO
Last Name:VALLE-EGER
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 1:6644 E BAYWOOD AVE
Mailing Address - Street 2:BANNER BAYWOOD MEDICAL CENTER
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206
Mailing Address - Country:US
Mailing Address - Phone:480-321-3900
Mailing Address - Fax:480-321-3840
Practice Address - Street 1:6644 E BAYWOOD AVE
Practice Address - Street 2:BANNER BAYWOOD MEDICAL CENTER
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-321-3900
Practice Address - Fax:480-321-3840
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50733207R00000X, 208M00000X
NMMD2019-0032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist