Michael J Bruwer, MD, PSYCH
Individual provider Active NPI Psychiatry Physician · Benson, AZ
NPI 1144394263 · NPPES record last updated Sep 13, 2007
Key facts
- NPI
- 1144394263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- PSYCH 9113 (AZ)
- Practice address
- 470 S Ocotillo Ave
Benson, AZ 85602-6403 - Phone
- (520) 586-7737
- Fax
- (520) 586-7939
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSYCH 9113 | AZ | MD | Psychiatry Physician |
| 9113 | AZ | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | PSYCH 9113 | AZ | Yes |
Addresses
Primary practice location
470 S Ocotillo Ave
Benson, AZ 85602-6403
Mailing address
PO Box 42167
Tucson, AZ 85733-2167
Phone (520) 326-9239
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 258831 | Other | AZ | AHCCCS |
Other providers in Benson, AZ
- Susan May Boge
- Gouni Lakoso Bouraima
- Marymar Boyer
- Amanda Marie Branda
- Penelope Bruning
- Robert Lance Bryant
- Dianna Burchard
- Yassar E Canchola
- Sarah Lynne Cargile
- Caring Connections for Special Needs, LLC
All providers in Benson, AZ · Psychiatry Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.