Individual
TAMARA M BRUNKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 662-7355
(215) 349-8444
Mailing address
3400 SPRUCE ST, 9 FOUNDERS, PHILADELPHIA, PA 19104-4206
(215) 662-7355
(215) 349-8444
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA001291L
PA
363AM0700X
Medical Physician Assistant
MP000369
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3K5950
HEALTHNET
—
01
—
43877
UNIVERSITY HEALTH PLAN
—
Enumeration date
07/21/2006
Last updated
08/15/2013
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