Provider Demographics
NPI:1568506186
Name:SECKELER, MICHAEL DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:SECKELER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:BANNER UNIVERSITY MEDICAL CENTER
Mailing Address - Street 2:PO BOX 245073
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724
Mailing Address - Country:US
Mailing Address - Phone:520-626-5585
Mailing Address - Fax:520-626-6571
Practice Address - Street 1:1501 N CAMPBELL AV
Practice Address - Street 2:ROOM 3302
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724
Practice Address - Country:US
Practice Address - Phone:520-626-5585
Practice Address - Fax:520-626-6571
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2023-09-12
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Provider Licenses
StateLicense IDTaxonomies
AZ35588207RA0002X, 208000000X, 2080P0202X
MP0418208000000X
VA01012450202080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No207RA0002XAllopathic & Osteopathic PhysiciansInternal MedicineAdult Congenital Heart Disease
No208000000XAllopathic & Osteopathic PhysiciansPediatrics