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General NPI Number Information
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NPI Number | 1861488736
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Entity Type | Individual
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Provider Name | DAVID M MEDUNICK DO
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Gender | Male
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 10419 E MCDOWELL MOUNTAIN RANCH RD STE A100
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-8697
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Country | US
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Telephone | 480-882-7530
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Fax | 480-513-3224
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Provider Business Mailing Address
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Address Line | 2500 W UTOPIA RD STE 100
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City | PHOENIX
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State | AZ
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Zip | 85027-4172
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Country | US
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Telephone | 623-683-4462
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Fax | 623-683-4963
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB07739200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 008575
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License Number State | AZ
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