Provider Demographics
NPI:1003015918
Name:STUMPF, MICHAEL J (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:STUMPF
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 1:29455 N. CAVE CREEK RD STE #118-451
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85331
Mailing Address - Country:US
Mailing Address - Phone:844-436-7874
Mailing Address - Fax:877-828-6834
Practice Address - Street 1:20940 N. TATUM BLVD. STE #350
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050
Practice Address - Country:US
Practice Address - Phone:844-436-7874
Practice Address - Fax:877-828-6834
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10828208600000X
AZ4658208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ270795Medicaid