Individual
MICHAEL THORPE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
370 E VIRGINIA AVE STE 100, PHOENIX, AZ 85004-1254
(614) 293-8652
Mailing address
370 E VIRGINIA AVE STE 100, PHOENIX, AZ 85004-1254
(602) 258-4788
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
AO5603724206896
OH
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
58871
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
553192
—
AZ
Enumeration date
07/19/2012
Last updated
10/18/2019
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