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General NPI Number Information
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NPI Number | 1447780374
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Entity Type | Individual
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Provider Name | MICHAEL HENRY VIEIRA MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 2202 N STOCKTON HILL RD STE 100
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City | KINGMAN
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State | AZ
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Zip | 86401-4622
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Country | US
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Telephone | 928-681-8706
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Fax | 928-681-8707
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Provider Business Mailing Address
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Address Line | 3269 N STOCKTON HILL RD
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City | KINGMAN
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State | AZ
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Zip | 86409-3619
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Country | US
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Telephone | 928-263-4722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 62387
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License Number State | AZ
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