Healthcare Provider Details

I. General information

NPI: 1902037583
Provider Name (Legal Business Name): MR. MICHAEL BUCHSBAUM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E WATSON DR
TEMPE AZ
85283-3147
US

IV. Provider business mailing address

4435 E OXFORD LN
GILBERT AZ
85295-5822
US

V. Phone/Fax

Practice location:
  • Phone: 480-897-6063
  • Fax:
Mailing address:
  • Phone: 928-853-6429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4199490
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: