Provider Demographics
NPI:1558986711
Name:ORME, MICHELLE (NMD)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:ORME
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 E BROADWAY RD UNIT 2057
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1779
Mailing Address - Country:US
Mailing Address - Phone:704-258-4337
Mailing Address - Fax:
Practice Address - Street 1:2134 E BROADWAY RD UNIT 2057
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1779
Practice Address - Country:US
Practice Address - Phone:704-258-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20-1870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine