Provider Demographics
NPI:1992281463
Name:MICHAEL G DURAN LLC
Entity type:Organization
Organization Name:MICHAEL G DURAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-297-3028
Mailing Address - Street 1:3820 W HAPPY VALLEY RD STE 175
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-3289
Mailing Address - Country:US
Mailing Address - Phone:623-297-3028
Mailing Address - Fax:
Practice Address - Street 1:2155 E CONFERENCE DR STE 111
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-2604
Practice Address - Country:US
Practice Address - Phone:480-839-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty