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Individual
DR. MICHAEL MORTENSEN
Active
Individual
DR. MICHAEL MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
005862
AZ
207R00000X
Internal Medicine Physician
R1693
AZ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
005862
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
716555
—
AZ
Enumeration date
06/09/2009
Last updated
08/02/2021
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