| 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: Not Enrolled in Medicare 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 |