Provider Demographics
NPI:1225481740
Name:PRAMHUS, ALEC (MD)
Entity Type:Individual
Prefix:
First Name:ALEC
Middle Name:
Last Name:PRAMHUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S WATSON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-3451
Mailing Address - Country:US
Mailing Address - Phone:602-726-8750
Mailing Address - Fax:623-474-5811
Practice Address - Street 1:525 S WATSON RD STE 200
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-3451
Practice Address - Country:US
Practice Address - Phone:602-726-8750
Practice Address - Fax:623-474-5811
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10652207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ58323OtherFAMILY MEDICINE