Provider Demographics
NPI:1588667596
Name:JERMAN, MICHAEL RAMSEY (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RAMSEY
Last Name:JERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10238 E HAMPTON AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3321
Mailing Address - Country:US
Mailing Address - Phone:480-889-1573
Mailing Address - Fax:480-889-1574
Practice Address - Street 1:10238 E HAMPTON AVE STE 501
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3321
Practice Address - Country:US
Practice Address - Phone:480-889-1573
Practice Address - Fax:480-889-1574
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17678207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5014510OtherCCN
AZ10076433OtherPPO NEXT
AZ1Z2507OtherHEALTH NET
AZ278433Medicaid
AZ100665OtherONE HEALTH
AZ7952545OtherGHI
AZ005502301OtherCIGNA
AZ3503OtherARIZONA MEDICAL NETWORK
AZ22663OtherPREFERRED HEALTH NETWORK
AZ4062282OtherAETNA
AZ52415OtherFIRST HEALTH
AZ060057127OtherRAILROAD MEDICARE
AZAZ0860290OtherBCBS OF ARIZONA
AZ1Z2507OtherHEALTH NET
AZ278433Medicaid
AZZ101623Medicare PIN
AZAZ0860290OtherBCBS OF ARIZONA
AZ3503OtherARIZONA MEDICAL NETWORK
139765Medicare PIN
AZZ61511Medicare PIN
AZ100665OtherONE HEALTH