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Contact Information

MICHAEL J PUCHOWICZ, MD
4830 HIGHWAY 260
SUITE 102
LAKESIDE, AZ85929-5845
 Phone: 928-537-1040
 Fax: 928-537-1042
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2080S0010X 37 Physician/Pediatric Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MICHAEL J PUCHOWICZ · (Male)

NPI # 1134452303
Status Active
Credentials MD
Entity Individual
Enumeration date 09/04/2009
Last updated 04/06/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 44940
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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