Individual
DR. JAMES MICHAEL UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
44572 W BOWLIN RD, MARICOPA, AZ 85138
(520) 568-2316
(520) 568-2316
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
007525
AZ
208000000X
Pediatrics Physician
OH34007098
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000354015
BLUE CROSS BLUE SHIELD PI
OH
05
—
2137860
—
OH
Enumeration date
06/13/2005
Last updated
05/30/2018
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