Gravdahl, Daniel Joseph

Gravdahl, Daniel Joseph is an sole proprietor health care provider with primary practice located at 4207 E Cotton Center Blvd. Building 10, Phoenix AZ 85040. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Gravdahl, Daniel Joseph can be contacted via phone (888) 276-2223.

Contact Information

Primary practice address
4207 E Cotton Center Blvd. Building 10 Phoenix AZ 85040
Phone: (888) 276-2223
Fax: (972) 767-0225
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 44276 Arizona
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 81039 Arizona

Profile Details

NPI number 1225229115
LBN Legal business name Gravdahl, Daniel Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 6th, 2007
Last updated Nov 25th, 2013 - about 13 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 1225229115 NPPES
Arizona Other 81039 TRAINING PERMIT

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