Healthcare Provider Details

I. General information

NPI: 1275502544
Provider Name (Legal Business Name): MICHAEL ALAN BOXER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 N WILMOT RD STE 151
TUCSON AZ
85711-2701
US

IV. Provider business mailing address

1760 E RIVER RD STE 350
TUCSON AZ
85718-5999
US

V. Phone/Fax

Practice location:
  • Phone: 520-886-0206
  • Fax: 520-886-0829
Mailing address:
  • Phone: 520-519-7775
  • Fax: 520-519-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number9268
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: