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NPI Code Detail

MEDICARE: DR. MICHAEL HERRERA D.O.

MEDICARE: DR. MICHAEL HERRERA D.O.
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
1207Q00000XFamily Medicine Physician4489AZ

Other Identifiers

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

General Provider Information

NPI Number : 1871610774
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL HERRERA D.O.
Provider Business Mailing Address
First Line : 102 WOODMONT BLVD STE 600
Second Line :
City : NASHVILLE
State : TN
Zip : 37205-5250
Country : US
Telephone Number : 615-315-5257
Fax Number : 615-692-0547
Provider Business Practice Location Address
First Line : 4315 E MAIN STREET
Second Line :
City : MESA
State : AZ
Zip : 85205-8605
Country : US
Telephone Number : 480-870-7500
Fax Number : 480-870-7502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 06/30/2023

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