Individual
MICHAEL DEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
7425 E SHEA BLVD, STE 108, SCOTTSDALE, AZ 85260
(520) 290-0022
(520) 290-0044
Mailing address
7900 E PRINCESS DR, STE 2028, SCOTTSDALE, AZ 85255
(480) 206-2868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3309
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
985111
—
AZ
Enumeration date
06/28/2006
Last updated
07/08/2007
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