Individual
PETER P MICHALAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1631 W INA RD, TUCSON, AZ 85704-1985
(520) 585-5738
(520) 585-5843
Mailing address
5055 E BROADWAY BLVD STE A100, TUCSON, AZ 85711-3629
(520) 327-0460
(520) 795-0225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64431
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64431
AZ LICENSE
AZ
Enumeration date
03/27/2018
Last updated
02/11/2022
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