Provider Demographics
NPI:1710964275
Name:LESSLER, MICHAELA (MD)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:LESSLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:
Other - Last Name:STANCIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3330 N 2ND ST
Mailing Address - Street 2:STE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2369
Mailing Address - Country:US
Mailing Address - Phone:602-265-8965
Mailing Address - Fax:602-650-0578
Practice Address - Street 1:9700 N 91ST ST
Practice Address - Street 2:STE A200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5054
Practice Address - Country:US
Practice Address - Phone:480-614-2000
Practice Address - Fax:480-614-1751
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34049207RC0200X, 207RP1001X, 207RS0012X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ34049OtherMD LICENSE
AZZ133036OtherINDIV MEDCICARE PTAN
AZZ133035OtherGROUP MEDICARE PTAN
AZ985252Medicaid
AZZ133036OtherINDIV MEDCICARE PTAN