MEDICARE: MR. MICHAEL JEROME HERVEY II M.D.

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	207V00000X	Obstetrics & Gynecology Physician	45042	AZ

General Provider Information

NPI Number	:	1922132414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL JEROME HERVEY II M.D.

Provider Business Mailing Address
First Line	:	1300 N 12TH ST STE 620
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2850
Country	:	US
Telephone Number	:	602-283-3668
Fax Number	:	602-258-1710

Provider Business Practice Location Address
First Line	:	1300 N 12TH ST STE 620
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2850
Country	:	US
Telephone Number	:	602-283-3668
Fax Number	:	602-258-1710

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	12/19/2024

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