Organization
WHITE MOUNTAIN DERMATOLOGY LLC
Active
Organization
WHITE MOUNTAIN DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERARDO C BRUAL MD (PRESIDENT)
(480) 671-4086
Entity
Organization
Contact information
Practice address
288 N IRONWOOD DR, SUITE 105, APACHE JUNCTION, AZ 85220-3830
(480) 671-4086
Mailing address
288 N IRONWOOD DR, SUITE 105, APACHE JUNCTION, AZ 85220-3830
(480) 671-4086
(480) 671-4105
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070013565
RAIL ROAD MEDICARE
AZ
Enumeration date
05/23/2006
Last updated
04/07/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up