Healthcare Provider Details

I. General information

NPI: 1396704391
Provider Name (Legal Business Name): MICHAEL WILLIAM EDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9327 N 3RD ST SUITE 200
PHOENIX AZ
85020
US

IV. Provider business mailing address

PO BOX 26861
PHOENIX AZ
85068
US

V. Phone/Fax

Practice location:
  • Phone: 602-348-4360
  • Fax: 602-943-4808
Mailing address:
  • Phone: 602-348-4360
  • Fax: 602-943-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number10030
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number23410
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: