Provider Demographics
NPI:1326009069
Name:BISCHOF, MICHAEL F (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:BISCHOF
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:5055 E BROADWAY BLVD
Mailing Address - Street 2:A100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3640
Mailing Address - Country:US
Mailing Address - Phone:520-327-0460
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:7229 N THORNYDALE RD
Practice Address - Street 2:SUITE 137
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2097
Practice Address - Country:US
Practice Address - Phone:520-744-2900
Practice Address - Fax:520-744-3318
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2012-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ1576207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ118046OtherMEDICARE PTAN
AZZ118046OtherMEDICARE PTAN