Individual
DAN SHTUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 522-9400
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(480) 375-0123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
008728
AZ
390200000X
Student in an Organized Health Care Education/Training Program
R3299
AZ
Other
Enumeration date
07/04/2019
Last updated
05/07/2021
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