Healthcare Provider Details

I. General information

NPI: 1710944046
Provider Name (Legal Business Name): MICHAEL D. SAPOZINK M.D.,PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2926 N CIVIC CENTER PLZ
SCOTTSDALE AZ
85251-6902
US

IV. Provider business mailing address

345 W LAWRENCE RD
PHOENIX AZ
85013-1123
US

V. Phone/Fax

Practice location:
  • Phone: 480-613-6300
  • Fax:
Mailing address:
  • Phone: 602-266-7408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number20542
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: