Individual
JASON D MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14275 N 87TH ST STE 110, SCOTTSDALE, AZ 85260-3696
(480) 905-7274
(480) 905-7274
Mailing address
3800 PARK NICOLLET BLVD, DERMATOLOGY DEPARTMENT - 4TH FLOOR, ST LOUIS PARK, MN 55416-2527
(952) 993-3123
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
44434
AZ
207N00000X
Dermatology Physician
57833
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
658351
—
AZ
Enumeration date
05/18/2010
Last updated
03/11/2020
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