Individual
DR. DEAN D ETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2581 E MURDOCH CT, GREEN VALLEY, AZ 85614
(520) 266-3549
Mailing address
155 CALLE PORTAL, SUITE 200, SIERRA VISTA, AZ 85635-2900
(520) 458-0660
(520) 458-9550
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
AZ12142
AZ
208000000X
Pediatrics Physician
12142
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548257009
PERSONAL NPI
—
01
—
1689925711
GROUP NPI
—
05
—
235079002
—
AZ
Enumeration date
09/30/2005
Last updated
08/07/2018
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