Healthcare Provider Details

I. General information

NPI: 1568760536
Provider Name (Legal Business Name): MICHELLE ANNE ARISTIZABAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 02/18/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16700 N THOMPSON PEAK PKWY STE 130
SCOTTSDALE AZ
85260-2384
US

IV. Provider business mailing address

16700 N THOMPSON PEAK PKWY STE 130
SCOTTSDALE AZ
85260-2384
US

V. Phone/Fax

Practice location:
  • Phone: 480-454-4490
  • Fax: 480-546-5433
Mailing address:
  • Phone: 480-454-4490
  • Fax: 480-546-5433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA08966200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number61291
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: