Provider Demographics
NPI:1528182557
Name:STUTMAN, ROSS LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:LEWIS
Last Name:STUTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 E IRONWOOD SQUARE DR
Mailing Address - Street 2:STE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-6082
Mailing Address - Country:US
Mailing Address - Phone:480-948-8400
Mailing Address - Fax:480-948-8401
Practice Address - Street 1:9500 E IRONWOOD SQUARE DR STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4582
Practice Address - Country:US
Practice Address - Phone:480-948-8400
Practice Address - Fax:480-948-8401
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
AZ45970208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ45970OtherLICENSE
AZFS2594100OtherDEA