Individual
DR. MICHAEL IHSAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MPH
Contact information
Practice address
CORNER OF RT N12 AND N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Mailing address
P.O. BOX 649, FORT DEFIANCE INDIAN HOSPITAL BOARD, INC., FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
24197
OK
Other
Enumeration date
06/24/2005
Last updated
09/22/2011
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