Healthcare Provider Details

I. General information

NPI: 1275686008
Provider Name (Legal Business Name): MICHAEL DAVID NUNEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7920 E THOMPSON PEAK PKWY #100
SCOTTSDALE AZ
85255-7402
US

IV. Provider business mailing address

7920 E THOMPSON PEAK PKWY #100
SCOTTSDALE AZ
85255-7402
US

V. Phone/Fax

Practice location:
  • Phone: 480-661-1679
  • Fax: 480-661-4125
Mailing address:
  • Phone: 480-661-1679
  • Fax: 480-661-4125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26916
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: