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General NPI Number Information
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NPI Number | 1508042334
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Entity Type | Individual
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Provider Name | GIOVANI IVAN MICHIELI M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 2201 E CAMELBACK RD STE 101A
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City | PHOENIX
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State | AZ
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Zip | 85016-3495
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Country | US
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Telephone | 888-663-6331
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 2201 E CAMELBACK RD STE 101A
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City | PHOENIX
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State | AZ
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Zip | 85016-3495
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Country | US
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Telephone | 602-218-4075
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Fax | 602-218-4076
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 42022
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License Number State | AZ
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