Dr. Dustin L. Nissen, M.D.
Family Medicine in Phoenix, AZ. Individual provider (NPI-1).
NPI number1508147232
StatusActive
Last updated in NPPESSep 8, 2014
Details
- NPI
- 1508147232
- Entity type
- Individual (NPI-1)
- Name
- Dr. Dustin L. Nissen
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 8, 2011
- Last updated
- Sep 8, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 48734 | AZ | Yes |
Practice location
4530 E Muirwood Dr#105
Phoenix, AZ 85048-7639
Phone 480-961-2303 · Fax 480-961-2306
Mailing address
4530 E Muirwood Dr#105
Phoenix, AZ 85048-7639
Phone 480-961-2303 · Fax 480-961-2306
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