Individual
DR. DEAN D ETTINGER
Active
Individual
DR. DEAN D ETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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