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Individual

ERIKA R BRACAMONTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1501 N CAMPBELL AVE, TUCSON, AZ 85724-0001
(520) 874-4135
(520) 874-7048
Mailing address
2701 E ELVIRA RD, TUCSON, AZ 85706-7124
(520) 874-4135
(520) 874-7048

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
36183
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
172281
AZ
01
36183
MD LICENSE
AZ
01
P00387430
RR MEDICARE
AZ
01
ZWCGCR
GROUP MEDICARE NUMBER
AZ
Enumeration date
12/22/2006
Last updated
05/29/2008
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