Tieman, Michael Edward

Tieman, Michael Edward is an individual health care provider with primary practice located at 5171 Cub Lake Rd Suite 280, Show Low AZ 85901-7866. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Tieman, Michael Edward can be contacted via phone (928) 532-5463.

Contact Information

Primary practice address
5171 Cub Lake Rd Suite 280 Show Low AZ 85901-7866
Phone: (928) 532-5463
Fax: (928) 532-8474
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 27787 Arizona
Allopathic & Osteopathic Physicians / Surgery 208600000X 22553 Wisconsin

Profile Details

NPI number 1730150400
LBN Legal business name Tieman, Michael Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730150400 NPPES
Arizona Other AZ0732060 BLUE CROSS BLUE SHIELD AZ
Arizona MEDICAID 478942 BLUE CROSS BLUE SHIELD AZ

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