Provider Demographics
NPI:1962471425
Name:FOLEY, MICHAEL RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RAYMOND
Last Name:FOLEY
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 1:1331 N 7TH ST
Mailing Address - Street 2:SUITE 275
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2754
Mailing Address - Country:US
Mailing Address - Phone:602-257-8118
Mailing Address - Fax:602-528-0099
Practice Address - Street 1:1331 N 7TH ST
Practice Address - Street 2:SUITE 275
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2754
Practice Address - Country:US
Practice Address - Phone:602-257-8118
Practice Address - Fax:602-528-0099
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19148207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91191486Medicaid
AZ294661Medicaid
NMU3633Medicaid
AZ16WCGKW09Medicare ID - Type Unspecified
CO91191486Medicaid