Individual
DR. MICHAEL JAMES PHEND
Active
Individual
DR. MICHAEL JAMES PHEND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01030254A
IN
208M00000X
Hospitalist Physician
01030254A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000527516
ANTHEM
IN
01
—
000000626560
BCBS
IN
01
—
000000705131
ANTHEM PROVIDER NUMBER - TIN 35-2030653
IN
05
—
100112690
—
IN
Enumeration date
06/23/2006
Last updated
05/17/2012
Update your record
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