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General NPI Number Information
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NPI Number | 1437185600
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Entity Type | Individual
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Provider Name | ADAM M. KRUCZAY DPM
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 2815 S ALMA SCHOOL RD #119B
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City | MESA
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State | AZ
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Zip | 85210-4031
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Country | US
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Telephone | 480-664-7490
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Fax | 480-664-7512
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Provider Business Mailing Address
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Address Line | 2487 S GILBERT RD #106-606
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City | GILBERT
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State | AZ
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Zip | 85295-8899
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Country | US
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Telephone | 480-664-7490
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Fax | 480-664-7512
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC003387L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0676
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License Number State | AZ
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