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NPI Code Detail

MEDICARE: MICHAEL CHRISTOPHER VIZACHERO M.D.

MEDICARE: MICHAEL CHRISTOPHER VIZACHERO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician4301112721MI

General Provider Information

NPI Number : 1164834818
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL CHRISTOPHER VIZACHERO M.D.
Provider Business Mailing Address
First Line : 2880 MISSION DR
Second Line :
City : SHELBYVILLE
State : MI
Zip : 49344-9580
Country : US
Telephone Number : 269-397-1760
Fax Number : 269-397-1764
Provider Business Practice Location Address
First Line : 2880 MISSION DR
Second Line :
City : SHELBYVILLE
State : MI
Zip : 49344-9580
Country : US
Telephone Number : 269-397-1760
Fax Number : 269-397-1764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2014
Last Update Date : 11/19/2025

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