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Contact Information

PETER NIEMCZYK, MD
5171 CUB LAKE RD
BLDG C STE 340
SHOW LOW, AZ85901-7888
 Phone: 928-537-0111
 Fax: 623-582-9666
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for PETER NIEMCZYK · (Male)

NPI # 1518953041
Status Active
Credentials MD
Entity Individual
Enumeration date 09/20/2005
Last updated 05/21/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # 34718
  • AZ Medicaid 477100
  • Other 5135633 AETNA
  • Other 674661 CIGNA
  • Other P00378324 RAILROAD MEDICARE
  • AZ Other AZ0156450 BLUE CROSS BLUE SHIELD
  • AZ Other 2Z2716 HEALTHNET
Hospital affiliation(s)
  • BENSON HOSPITAL - (Critical Access)
    450 SOUTH OCOTILLO STREET
    BENSON, AZ 85602
  • COPPER QUEEN COMMUNITY HOSPITAL - (Critical Access)
    101 COLE AVENUE
    BISBEE, AZ 85603
  • SIERRA VISTA REGIONAL HEALTH CENTER INC - (Acute Care)
    300 EL CAMINO REAL
    SIERRA VISTA, AZ 85635
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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