Michael D Dersam MD PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

AZ30263 Issued in AZ

Legal business name

MICHAEL D DERSAM MD PC

Practice address

2222 E Highland Ave
Suite 425
Phoenix, AZ 85016

Phone

(602) 667-6640

Fax

(602) 522-2677

NPI assigned

Mar 12, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Daniel Dersam, MD

Title

Owner

Phone

(602) 667-6640

Specialties & licenses 2

Addresses

Other names 1

• Michael D Dersam MD PC an Arizona Professional Corporation Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1821269374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "SUITE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85016",
            "telephone_number": "602-667-6640",
            "fax_number": "602-522-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "SUITE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85016",
            "telephone_number": "602-667-6640",
            "fax_number": "602-522-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D DERSAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "DERSAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-667-6640",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "30263",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "AZ30263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael D Dersam MD PC an Arizona Professional Corporation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Dean J Micalizio, D.C.
• Camilla Ann Mican, MD
• Amy Elizabeth Miceli, PA-C
• Micgra Psych
• Michael B. Lebowitz DDS PC
• Michael G. Nadauld, DMD PLLC
• Michael J Brennan MD PC
• Michael J Sekosky
• Michael J. Radcliffe, DMD,PC
• Michael K Ofori MD PC

• Orthopaedic Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.