Provider Demographics
NPI:1275686008
Name:NUNEZ, MICHAEL DAVID (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 E THOMPSON PEAK PKWY
Mailing Address - Street 2:#100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7402
Mailing Address - Country:US
Mailing Address - Phone:480-661-1679
Mailing Address - Fax:480-661-4125
Practice Address - Street 1:7920 E THOMPSON PEAK PKWY
Practice Address - Street 2:#100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7402
Practice Address - Country:US
Practice Address - Phone:480-661-1679
Practice Address - Fax:480-661-4125
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26916207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ26916OtherAZ STATE LICENCE
AZ65763Medicare ID - Type Unspecified
AZH10314Medicare UPIN