Provider Demographics
NPI:1225013022
Name:DELEEUW, KAREL A (MD)
Entity type:Individual
Prefix:DR
First Name:KAREL
Middle Name:A
Last Name:DELEEUW
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 1:34522 N SCOTTSDALE RD # 404
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-1224
Mailing Address - Country:US
Mailing Address - Phone:480-495-3356
Mailing Address - Fax:
Practice Address - Street 1:1441 N 12TH ST FL 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2837
Practice Address - Country:US
Practice Address - Phone:602-521-5977
Practice Address - Fax:602-521-5151
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND23321223S0112X
AZD06081204E00000X
NDPT15017204E00000X
ND15017204E00000X
AZ32072207Y00000X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ86080015085259C381OtherTRIWEST
AZ816936Medicaid
MOMRM5813Medicaid
AZP00150696OtherRAILROAD MEDICARE
AZP00150696OtherRAILROAD MEDICARE
E07830Medicare UPIN