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General NPI Number Information
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NPI Number | 1891971628
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Entity Type | Individual
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Provider Name | JEANETTE ANUDDIN CRUZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 16928 W BELL RD STE 701
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City | SURPRISE
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State | AZ
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Zip | 85374-8948
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Country | US
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Telephone | 623-850-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 2661 LARCH DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-1889
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Country | US
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Telephone | 480-789-0814
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Fax | 480-789-0814
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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 | 81714
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License Number State | AZ
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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 | 4301095410
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 42393
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License Number State | AZ
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