MEDICARE: DR. MICHAEL GORDON DURAN MD

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
1	207L00000X	Anesthesiology Physician	31858	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1801862396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL GORDON DURAN MD

Provider Business Mailing Address
First Line	:	3820 W HAPPY VALLEY RD # 175
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85310-3289
Country	:	US
Telephone Number	:	623-297-3028
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 W HAPPY VALLEY RD # 175
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85310-3289
Country	:	US
Telephone Number	:	623-297-3028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	09/11/2018

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