Healthcare Provider Details

I. General information

NPI: 1427129964
Provider Name (Legal Business Name): EAST VALLEY RHEUMATOLOGY & OSTEOPOROSIS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 E BASELINE RD SUITE 108
GILBERT AZ
85234-2727
US

IV. Provider business mailing address

3921 E BASELINE RD SUITE 108
GILBERT AZ
85234-2727
US

V. Phone/Fax

Practice location:
  • Phone: 480-820-7474
  • Fax: 480-820-7444
Mailing address:
  • Phone: 480-820-7474
  • Fax: 480-820-7444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBRA MICHEL
Title or Position: PRESIDENT
Credential: MD
Phone: 480-820-7474