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Individual

DR. DANIEL M. JONDLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1300 N 12TH ST, SUITE 300, PHOENIX, AZ 85006-2848
(602) 687-7468
(602) 687-7683
Mailing address
3260 N HAYDEN RD STE 112, SCOTTSDALE, AZ 85251-6650
(602) 687-7468
(602) 264-9101

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35979
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
86942
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
DR42367
CO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME94604
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120390
GROUP MEDICARE NUMBER
AZ
01
317047
GROUP MEDICAID NUMBER
AZ
Enumeration date
12/14/2005
Last updated
01/04/2023
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