| Organization Name: | MICHAEL R DURHAM MD |
| NPI Number: | 1144245127 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL R DURHAM (OWNER) |
| Mailing Address: | 703 E Ash St Globe |
| State: | AZ US |
| Postal Code: | 855011865 |
| Phone Number: | 9284254467 |
| Fax Number: | 9284256166 |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 11/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 14893 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |