Individual
DR. MICHAEL ANTHONY SEIVERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4611 E SHEA BLVD, SUITE 200, PHOENIX, AZ 85028-4254
(602) 265-9900
(602) 265-4130
Mailing address
4611 E SHEA BLVD, SUITE 200, PHOENIX, AZ 85028-4254
(602) 265-9900
(602) 265-4130
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2109
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611371700
(OWCP) DOL PROVIDER NO.
AZ
01
—
AZ0424940
BCBS PARTICIPATING PROV #
AZ
Enumeration date
07/13/2006
Last updated
07/14/2010
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