Madsen, Michael Robert
Madsen, Michael Robert is an sole proprietor health care provider with primary practice located at 6239 E Brown Rd Ste 105 , Mesa AZ 85205-4933. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Madsen, Michael Robert can be contacted via phone (480) 477-9199.Contact Information
Primary practice address
6239 E Brown Rd Ste 105
Mesa AZ 85205-4933
Phone: (480) 477-9199
Fax: (602) 610-1556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | Arizona |
Profile Details
| NPI number | 1205501392 |
|---|---|
| LBN Legal business name | Madsen, Michael Robert |
| Credentials | CPSS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 11th, 2021 |
| Last updated | Aug 11th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205501392 | NPPES |
| Arizona | MEDICAID | 1609334812 |
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