Individual
ERIC ERNEST PROMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5404
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5404
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
36088
AZ
207RH0003X
Hematology & Oncology Physician
G075656
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139080
—
AZ
01
—
P00420090
RAILROAD MEDICARE
AZ
Enumeration date
08/30/2006
Last updated
01/28/2013
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