Healthcare Provider Details

I. General information

NPI: 1225357395
Provider Name (Legal Business Name): DANIEL STONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 07/21/2022
Certification Date: 04/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 E MARYLAND AVE
PHOENIX AZ
85016-1302
US

IV. Provider business mailing address

1616 E MARYLAND AVE
PHOENIX AZ
85016-1302
US

V. Phone/Fax

Practice location:
  • Phone: 602-788-1521
  • Fax:
Mailing address:
  • Phone: 602-788-1521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number48545
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: