Individual
DUSTIN DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1705 W MAIN ST, MESA, AZ 85201-6920
(480) 964-2273
Mailing address
3033 N CENTRAL AVE STE 145, PHOENIX, AZ 85012-2808
(480) 964-2273
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69739
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69739
ARIZONA MEDICAL BOARD
AZ
Enumeration date
06/11/2014
Last updated
09/29/2023
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