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Individual

DR. ALBERTO BRONISCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
262 DANNY THOMAS PLACE, MS 0515, ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PLACE, MS 0515, ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842

Taxonomy

Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
36398
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00126518
MS
05
0030341
NJ
05
0071961
MT
05
009905345
AL
05
100847840A
OK
05
104677849
MI
05
1136395
LA
05
186358377A
GA
05
200336060A
KS
05
200400610A
IN
05
205951007
MO
05
2524085
OH
05
3496709
TN
05
360488800
MN
05
422400000
ME
05
563072
IA
05
64056849
KY
05
804030
AZ
Enumeration date
05/23/2005
Last updated
04/05/2011
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