Individual
MARICELA D GULBRONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9900857
NC
208000000X
Pediatrics Physician
TP387
KY
2080P0006X
Developmental - Behavioral Pediatrics Physician
9900857
NC
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
K0484
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5911657
—
NC
01
—
Q0085N
S.C. MEDICAID
SC
Enumeration date
06/03/2006
Last updated
06/26/2014
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