Provider Demographics
NPI:1053556241
Name:BUENAFE, MICHELLE ELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELLEN
Last Name:BUENAFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5046 E CORRINE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4143
Mailing Address - Country:US
Mailing Address - Phone:480-628-8812
Mailing Address - Fax:
Practice Address - Street 1:5046 E CORRINE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4143
Practice Address - Country:US
Practice Address - Phone:480-628-8812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41015208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics