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General NPI Number Information
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NPI Number | 1154762581
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Entity Type | Organization
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Legal Business Name | STUTMAN PLASTIC SURGERY PC
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 12/31/2014
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Provider Practice Location Address
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Address Line | 9977 N 90TH ST STE 178
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4423
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Country | US
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Telephone | 480-488-3388
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Fax | 480-907-2405
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Provider Business Mailing Address
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Address Line | 8776 E SHEA BLVD STE 106-470
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6629
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Country | US
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Telephone | 480-488-3388
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Fax | 480-907-2405
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROSS L STUTMAN
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Credential | MD
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Telephone | 480-488-3388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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