Healthcare Provider Details

I. General information

NPI: 1215043195
Provider Name (Legal Business Name): DANIEL STEPHEN DUICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9328 E RAINTREE DR
SCOTTSDALE AZ
85260-2098
US

IV. Provider business mailing address

9328 E RAINTREE DRIVE
SCOTTSDALE AZ
85260
US

V. Phone/Fax

Practice location:
  • Phone: 602-266-8463
  • Fax: 602-266-0122
Mailing address:
  • Phone: 602-266-8463
  • Fax: 602-266-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number11393
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: