Basic Information
| Provider Information | |||||||||
| NPI: | 1366592867 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAHUKEY | ||||||||
| FirstName: | AMRAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5300 E ERICKSON DR | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857122828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203266766 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5300 E ERICKSON DR STE 118 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857122809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203266766 | ||||||||
| FaxNumber: | 5203236660 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 06/02/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 0189 | AZ | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213EP1101X | 0189 | AZ | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Primary Podiatric Medicine | 213ES0103X | 0189 | AZ | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 213ES0131X | 0189 | AZ | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot Surgery |
ID Information
| ID | Type | State | Issuer | Description | 480009265 | 01 | AZ | RAILROAD MEDICARE | OTHER | 700288 | 05 | AZ | MEDICAID |