Ivchenko, Michael

Ivchenko, Michael is an individual health care provider with primary practice located at 2501 E Southern Ave Ste 14, Tempe AZ 85282. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Ivchenko, Michael can be contacted via phone (480) 730-3331.

Contact Information

Primary practice address
2501 E Southern Ave Ste 14 Tempe AZ 85282
Phone: (480) 730-3331
Fax: (480) 730-6340
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 15906 Arizona
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 35049133 Ohio
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X G57457 California

Profile Details

NPI number 1326014150
LBN Legal business name Ivchenko, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326014150 NPPES
Arizona MEDICAID 292384

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