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NPI Code Detail

MEDICARE: GIOVANI IVAN MICHIELI M.D.

MEDICARE: GIOVANI IVAN MICHIELI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician42022AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2Z22506OTHERAZMEDICARE GROUP PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508042334
Entity Type Code : Individual
Provider Name (Legal Business Name) : GIOVANI IVAN MICHIELI M.D.
Provider Business Mailing Address
First Line : 2201 E CAMELBACK RD STE 101A
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-3495
Country : US
Telephone Number : 602-218-4075
Fax Number : 602-218-4076
Provider Business Practice Location Address
First Line : 2201 E CAMELBACK RD STE 101A
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-3495
Country : US
Telephone Number : 888-663-6331
Fax Number : 415-252-7176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2008
Last Update Date : 03/17/2025

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