Michael Edward Tieman, MD | |
5171 Cub Lake Rd, Suite 280, Show Low, AZ 85901-7866 | |
(928) 532-5463 | |
(928) 532-8474 |
Full Name | Michael Edward Tieman |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 5171 Cub Lake Rd, Show Low, Arizona |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730150400 | NPI | - | NPPES |
AZ0732060 | Other | AZ | BLUE CROSS BLUE SHIELD AZ |
478942 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 27787 (Arizona) | Primary |
208600000X | Surgery | 22553 (Wisconsin) | Secondary |
Mailing Address | Practice Location Address |
---|---|
Michael Edward Tieman, MD Po Box 1660, Lakeside, AZ 85929-1660 Ph: (928) 532-5463 | Michael Edward Tieman, MD 5171 Cub Lake Rd, Suite 280, Show Low, AZ 85901-7866 Ph: (928) 532-5463 |
William J Waldo, MD Surgery Medicare: Medicare Enrolled Practice Location: 2650 E Show Low Lake Rd, Suite 2, Show Low, AZ 85901 Phone: 928-537-4240 Fax: 928-537-4541 | |
Dr. Burke Delange, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 5171 Cub Lake Rd, Suite C 350, Show Low, AZ 85901 Phone: 928-537-8285 |