Provider Demographics
NPI:1447447271
Name:MUNKWITZ, MICHELE M (MD)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:M
Last Name:MUNKWITZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3200 E CAMELBACK RD
Mailing Address - Street 2:STE 250
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2311
Mailing Address - Country:US
Mailing Address - Phone:602-933-1814
Mailing Address - Fax:602-933-1820
Practice Address - Street 1:5301 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2805
Practice Address - Country:US
Practice Address - Phone:602-933-1784
Practice Address - Fax:602-933-4298
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2021-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ443472080P0203X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ620401Medicaid