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NPI Code Detail

MEDICARE: MR. MICHAEL BUCHSBAUM

MEDICARE: MR. MICHAEL BUCHSBAUM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool Psychologist4199490AZ

General Provider Information

NPI Number : 1902037583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL BUCHSBAUM
Provider Business Mailing Address
First Line : 4435 E OXFORD LN
Second Line :
City : GILBERT
State : AZ
Zip : 85295-5822
Country : US
Telephone Number : 928-853-6429
Fax Number :
Provider Business Practice Location Address
First Line : 1600 E WATSON DR
Second Line :
City : TEMPE
State : AZ
Zip : 85283-3147
Country : US
Telephone Number : 480-897-6063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2009
Last Update Date : 05/19/2026

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