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Individual

DR. SHAUN E DEKUTOSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6677 W THUNDERBIRD RD, STE. A124, GLENDALE, AZ 85306-3709
(623) 773-2266
(623) 773-2267
Mailing address
2500 W UTOPIA RD, STE. 100, PHOENIX, AZ 85027-4171
(623) 434-6200
(623) 434-6164

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34578
MN
207Q00000X
Family Medicine Physician
Primary
48062
AZ

Other

Enumeration date
05/22/2006
Last updated
09/06/2013
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