DR. ERIC A HUETTL (NPI# 1861475097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861475097 |
| Entity Type | Individual |
| Full Name | DR. ERIC A HUETTL |
| Credential | M.D. |
| Practice Address |
5777 E Mayo Blvd Phoenix AZ 85054-4502 |
| Practice Telephone | 4803018000 |
| Mailing Telephone | 4803018000 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2007-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
22218 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | TRIWEST | 86080015085259A024 | 01 |
| AZ | 329707 | 05 |
| Street Address |
5777 E MAYO BLVD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85054-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740283878 | Charles J Manak | Internal Medicine | 5777 E Mayo Blvd, Phoenix, AZ 85054 | 2005-05-23 |
| 1871194563 | Courtney Comstock | Nurse Practitioner | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-11-08 |
| 1740819796 | Daniel Alan Salevitz | Student in an Organized Health Care Education/Training Program | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-04-02 |
| 1417586413 | Phylicia Dzifa Gawu | Student in an Organized Health Care Education/Training Program | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-04-02 |
| 1083242283 | Ashley Swan | Physician Assistant | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-04-01 |
| 1659909612 | Puneet Raman | Internal Medicine | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-03-27 |
| 1609403336 | Mary E Quense | Registered Nurse | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-03-24 |
| 1942836473 | Aditya Khurana | Student in an Organized Health Care Education/Training Program | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-03-16 |
| 1265064539 | Caitlin Marie Woerner | Registered Nurse | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-02-05 |
| 1730719972 | Sarah Pluto | Dietetic Technician, Registered | 5777 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-01-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992255301 | Stephanie Gamber | Registered Nurse | 5405 East Pinnacle Vista Drive, Phoenix, AZ 85054 | 2016-10-10 |
| 1508231960 | Deborah Elam | Acupuncturist | 5777 East Mayo Boulevard Mayo Clinic, Phoenix, AZ 85054 | 2015-12-09 |
| 1811176860 | Desert Ridge Pediatric Dentistry | Clinic/Center | 5315 E. High Street, Suite 115, Phoenix, AZ 85054 | 2007-10-26 |
| 1902968639 | Ryan David Schulze | Chiropractor | 7000 E Mayo Blvd Ste 1058, Phoenix, AZ 85054 | 2006-12-16 |
| 1477517423 | Gary Betz II Md PC | Internal Medicine | 7010 E. Chauncey Lane, Suite 145, Phoenix, AZ 85054 | 2006-04-14 |
| 1689658395 | Alice G Mccormick | Internal Medicine | 5450 East Deer Valley Drive Unit 3206, Phoenix, AZ 85054 | 2005-12-06 |
| 1770576241 | Michelle Renee Kuhn | Physician Assistant | 6950 E Chauncey Ln, Phoenix, AZ 85054 | 2005-08-30 |
| 1609869981 | Jeffrey Alan Smith | Optometrist | 18325 N Allied Way Ste 100, Phoenix, AZ 85054 | 2005-08-23 |
| 1043219389 | Hasan Khamash | Internal Medicine | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2005-07-19 |
| 1497753750 | Rajeev Agarwal | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2005-07-11 |
| Find all providers in zip 85054 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629242425 | Nelson R. De Lara | Radiology | 26 Glen Alpine Rd, Phoenix, MD 21131-2404 | 2008-04-14 |
| 1013387208 | Compcare Medical Group Inc | Radiology | 1021 S 7th Ave, Suite 102, Phoenix, AZ 85007-3725 | 2015-09-30 |
| 1669737714 | Ankit Harish Shah | Radiology | 2601 E Roosevelt St, Phoenix, AZ 85008 | 2012-07-05 |
| 1679835128 | Curtis Qin | Radiology | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2012-06-11 |
| 1053615021 | Arizona Interventional Medical Group PC | Radiology | 2338 W Royal Palm Rd, Suite J, Phoenix, AZ 85021-9339 | 2011-01-05 |
| 1093954554 | Vineel Kurli | Radiology | 10835 N 25th Ave, Suite 240, Phoenix, AZ 85029-4751 | 2009-02-06 |
| 1144482886 | Ahi Cardiovascular Surgeons Ltd | Radiology | 2632 N 20th St, Phoenix, AZ 85006-1339 | 2008-06-25 |
| 1104009109 | Interventional Radiology Plc | Radiology | 1800 E Van Buren St, Phoenix, AZ 85006-3742 | 2007-12-12 |
| 1235335324 | Lavi Nissim | Radiology | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2007-06-25 |
| 1427259555 | Grace Knuttinen | Radiology | 5777 E Mayo Blvd, Phoenix, AZ 85054 | 2007-05-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.