Individual
MICHAEL T TETZLAFF
Active
Individual
MICHAEL T TETZLAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
N6711
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MT185963
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214426301
—
TX
01
—
8CL001
BCBS
TX
01
—
P00881574
RRMEDICARE
TX
Enumeration date
01/02/2007
Last updated
04/10/2020
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