Organization
MICHAEL D DERSAM MD PC
Active
Other names
Michael D Dersam MD PC an Arizona Professional Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DANIEL DERSAM MD (OWNER)
(602) 667-6640
Entity
Organization
Contact information
Practice address
2222 E HIGHLAND AVE, SUITE 425, PHOENIX, AZ 85016
(602) 667-6640
(602) 522-2677
Mailing address
2222 E HIGHLAND AVE, SUITE 425, PHOENIX, AZ 85016
(602) 667-6640
(602) 522-2677
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
30263
AZ
207X00000X
Orthopaedic Surgery Physician
Primary
AZ30263
AZ
Other
Enumeration date
03/12/2008
Last updated
03/15/2018
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