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Individual

MICHAEL VAN OPEL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
R N F A

Contact information

Practice address
1715 W NORTHERN AVE, PHOENIX, AZ 85021-5472
(602) 395-0718
(602) 277-8146
Mailing address
PO BOX 39179, PHOENIX, AZ 85069-9179
(602) 395-0718
(602) 277-8146

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RN032563
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0163720
BLUE CROSS BLUE SHIELD
AR
Enumeration date
06/08/2006
Last updated
07/08/2007
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