Healthcare Provider Details

I. General information

NPI: 1366412462
Provider Name (Legal Business Name): DAVID A VERTULLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8144 E CACTUS RD SUITE 800
SCOTTSDALE AZ
85260-5266
US

IV. Provider business mailing address

8144 E CACTUS RD SUITE 800
SCOTTSDALE AZ
85260-5266
US

V. Phone/Fax

Practice location:
  • Phone: 480-596-8525
  • Fax: 480-596-8522
Mailing address:
  • Phone: 480-596-8525
  • Fax: 480-596-8522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number34938
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101050557
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: