Provider Demographics
NPI:1598099475
Name:MICHAEL F. ESBER DPM PC
Entity Type:Organization
Organization Name:MICHAEL F. ESBER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:ESBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:623-546-4930
Mailing Address - Street 1:14300 W GRANITE VALLEY DR
Mailing Address - Street 2:SUITE 5-B
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5783
Mailing Address - Country:US
Mailing Address - Phone:623-546-4930
Mailing Address - Fax:623-546-5979
Practice Address - Street 1:14520 W GRANITE VALLEY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5796
Practice Address - Country:US
Practice Address - Phone:623-546-4930
Practice Address - Fax:623-546-5979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDPM 358213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ109030Medicare PIN