Provider Demographics
NPI:1447323423
Name:KLEVEN, MICHAEL FLOYD (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FLOYD
Last Name:KLEVEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:702-579-3203
Mailing Address - Fax:702-838-1456
Practice Address - Street 1:15021 W BELL RD STE 125
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3916
Practice Address - Country:US
Practice Address - Phone:623-476-7880
Practice Address - Fax:623-476-7890
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ3680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ785579Medicaid
AZ785579Medicaid
H74294Medicare UPIN