Provider Demographics
NPI:1013185578
Name:BUYZE, MICHAEL T (CAC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:BUYZE
Suffix:
Gender:M
Credentials:CAC
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Mailing Address - Street 1:2600 N RICHMOND ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-1956
Mailing Address - Country:US
Mailing Address - Phone:920-997-0511
Mailing Address - Fax:920-968-8806
Practice Address - Street 1:2600 N RICHMOND ST
Practice Address - Street 2:SUITE C
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-1956
Practice Address - Country:US
Practice Address - Phone:920-997-0511
Practice Address - Fax:920-968-8806
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI214-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist