| Drew E Maris MD Professional Corporation | |
|
2400 Las Gallinas Ave Ste 120 San Rafael CA 94903-1456 | |
| (415) 455-0914 | |
| (415) 454-4315 |
| Full Name | Drew E Maris MD Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 2400 Las Gallinas Ave Ste 120, San Rafael, California |
| Authorized Official Name and Position | Drew E Maris (PHYSICIAN/OWNER) |
| Authorized Official Contact | 8315887816 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Drew E Maris MD Professional Corporation 2400 Las Gallinas Ave Ste 120 San Rafael CA 94903-1456 Ph: (415) 455-0914 | Drew E Maris MD Professional Corporation 2400 Las Gallinas Ave Ste 120 San Rafael CA 94903-1456 Ph: (415) 455-0914 |
| NPI Number | 1851033674 |
|---|---|
| Provider Enumeration Date | 04/12/2022 |
| Last Update Date | 07/15/2026 |
| Certification Date | 07/15/2026 |
| Medicare PECOS PAC ID | 0143607069 |
|---|---|
| Medicare Enrollment ID | O20220516001321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851033674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Drew E Maris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467538397 PECOS PAC ID: 6608941141 Enrollment ID: I20080819000533 |
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