Dudziak, Daniel G

Dudziak, Daniel G is an individual health care provider with primary practice located at 340 S Willard St , Cottonwood AZ 86326-4126. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dudziak, Daniel G can be contacted via phone (992) 639-6025.

Contact Information

Primary practice address
340 S Willard St Cottonwood AZ 86326-4126
Phone: (992) 639-6025
Fax: (928) 634-1117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 6391 Arizona

Profile Details

NPI number 1528040482
LBN Legal business name Dudziak, Daniel G
Credentials RPAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated May 14th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528040482 NPPES
Arizona MEDICAID 222212

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