Healthcare Provider Details

I. General information

NPI: 1275789877
Provider Name (Legal Business Name): DANIEL EDWARD KREUTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3645 S ROME ST STE 201
GILBERT AZ
85297-7338
US

IV. Provider business mailing address

4550 E BELL RD SUITE 170
PHOENIX AZ
85032-9306
US

V. Phone/Fax

Practice location:
  • Phone: 480-443-8400
  • Fax: 480-443-8697
Mailing address:
  • Phone: 480-443-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number44188
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: