Provider Demographics
NPI:1578527370
Name:VU, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:VU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1760 E RIVER RD
Mailing Address - Street 2:350
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5999
Mailing Address - Country:US
Mailing Address - Phone:520-519-7720
Mailing Address - Fax:520-519-5181
Practice Address - Street 1:3188 N WINDSONG DR
Practice Address - Street 2:# A
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-775-9430
Practice Address - Fax:928-775-9431
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ47084207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ935786Medicaid
AZ935786Medicaid
AZF38937Medicare UPIN
AZ935786Medicaid