MEDICARE: JONATHAN GABRIEL ZUESS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	29189	AZ
2	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	29189	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770541450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN GABRIEL ZUESS M.D.

Provider Business Mailing Address
First Line	:	4545 EAST SHEA BLVD.
Second Line	:	SUITE 174
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3061
Country	:	US
Telephone Number	:	602-923-1694
Fax Number	:	602-923-1913

Provider Business Practice Location Address
First Line	:	4545 EAST SHEA BLVD.
Second Line	:	SUITE 174
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3061
Country	:	US
Telephone Number	:	602-923-1694
Fax Number	:	602-923-1913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	01/28/2009

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