Michelle Dewolf Allen, DO | |
1220 S Higley Rd, Suite 101, Mesa, AZ 85206-4000 | |
(480) 615-2010 | |
(480) 324-0950 |
Full Name | Michelle Dewolf Allen |
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Gender | Female |
Speciality | Pediatrics |
Location | 1220 S Higley Rd, Mesa, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902896590 | NPI | - | NPPES |
611641 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 3693 (Arizona) | Primary |
Entity Name | Banner Primary Care Physicians Arizona Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417238908 PECOS PAC ID: 6406020155 Enrollment ID: O20111115000898 |
Entity Name | Banner Childrens Banner Health Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407191216 PECOS PAC ID: 2466697735 Enrollment ID: O20130315000131 |
Mailing Address | Practice Location Address |
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Michelle Dewolf Allen, DO Po Box 16455, Mesa, AZ 85211-6455 Ph: (480) 615-2075 | Michelle Dewolf Allen, DO 1220 S Higley Rd, Suite 101, Mesa, AZ 85206-4000 Ph: (480) 615-2010 |
Jyoti S. Lebonheur, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1840 S. Stapley Drive, Suite 101, Mesa, AZ 85204 Phone: 480-464-8500 | |
Dr. Eric Gabriel Gonzalez, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 616 E Southern Ave, #103, Mesa, AZ 85204 Phone: 602-569-3999 Fax: 602-569-3887 | |
Pacita Tee Opulencia, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 59 S Hibbert, Mesa, AZ 85210 Phone: 480-344-6226 Fax: 602-344-6201 | |
Dr. Daniel E Miga, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1432 S Dobson Rd Ste 512, Mesa, AZ 85202 Phone: 480-412-6336 Fax: 480-412-8013 | |
Naresh Reddivalla, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1432 S Dobson Rd Ste 107, Mesa, AZ 85202 Phone: 480-412-4100 | |
Dale W Guthrie, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4540 E Baseline Rd, Suite 108, Mesa, AZ 85206 Phone: 480-892-3880 Fax: 480-545-4551 | |
Dr. Leno Mammen Thomas, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1432 S Dobson Rd Ste 506, Mesa, AZ 85202 Phone: 480-412-6430 |