Provider Demographics
NPI:1538150321
Name:BISCOE, MICHAEL STUART (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STUART
Last Name:BISCOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 63423
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85082-3423
Mailing Address - Country:US
Mailing Address - Phone:480-892-2800
Mailing Address - Fax:480-982-1400
Practice Address - Street 1:4838 E BASELINE RD
Practice Address - Street 2:BLDG. 2 STE. 110
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4671
Practice Address - Country:US
Practice Address - Phone:480-892-2800
Practice Address - Fax:480-892-3258
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ20915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ119182Medicaid
AZZ110802Medicare PIN
D08163Medicare UPIN
AZ119182Medicaid
AZZ110801Medicare PIN