Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 4509 | AZ |
N | 207QA0401X | Family Doctor - Addiction Medicine | 4509 | AZ |
NPI | 1720245806 |
---|---|
Provider Name | Michael J Ahmann |
First Address | Scottsdale, AZ 85258-5534 |
Second Address | Scottsdale, AZ 85258-5562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2008 |
Last Update Date | 06/11/2019 |