Provider Demographics
NPI:1215043195
Name:DUICK, DANIEL STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEPHEN
Last Name:DUICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9328 E RAINTREE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:602-266-8463
Mailing Address - Fax:602-266-0122
Practice Address - Street 1:9328 E RAINTREE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2098
Practice Address - Country:US
Practice Address - Phone:602-266-8463
Practice Address - Fax:602-266-0122
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11393207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
C99398Medicare UPIN
Z23630Medicare ID - Type Unspecified