Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael D Dersam MD PC

Organization Specialist · NPI 1821269374

Michael D Dersam MD PC is a Specialist in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2008.

Licensed in
AZ
In the registry since
2008
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2222 E Highland Ave Ste 425
Phoenix, AZ 85016
Phone: (602) 667-6640
Fax: (602) 522-2677
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence AZ30263 (AZ)
Specialist Taxonomy 174400000X · Licence 30263 (AZ)

Record details

NPI number1821269374
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Dersam — Owner · (602) 667-6640
Other names Michael D Dersam Md Pc An Arizona Professional Corporation
NPI enumeratedMarch 12, 2008
Last updated in NPPESJune 16, 2026
Certification dateJune 16, 2026
Mailing address2222 E Highland Ave, Suite 425, Phoenix, AZ 85016

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