Healthcare Provider Details

I. General information

NPI: 1396942595
Provider Name (Legal Business Name): YOAAV S KRAUTHAMMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 E BELL RD STE 3100
PHOENIX AZ
85032-2136
US

IV. Provider business mailing address

3805 E BELL RD STE 3100
PHOENIX AZ
85032-2136
US

V. Phone/Fax

Practice location:
  • Phone: 602-867-8644
  • Fax: 602-606-5128
Mailing address:
  • Phone: 602-494-3656
  • Fax: 602-867-3862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number61943
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: