Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | R3429 | AZ |
NPI | 1003445503 |
---|---|
Provider Name | Dr. Matthew Kunz |
First Address | Phoenix, AZ 85012-2071 |
Second Address | Phoenix, AZ 85008-4973 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2020 |
Last Update Date | 15/12/2021 |