MEDICARE: MICHELLE MUSQUIZ

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
1	171W00000X	Contractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295885267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MUSQUIZ

Provider Business Mailing Address
First Line	:	7820 E BROADWAY BLVD STE 100
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-3939
Country	:	US
Telephone Number	:	520-721-1887
Fax Number	:

Provider Business Practice Location Address
First Line	:	6542 W HARBIN RIDGE WAY
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85757-1512
Country	:	US
Telephone Number	:	520-721-1887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/08/2007

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Directions to “ MICHELLE MUSQUIZ ” Practice Location

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