Provider Demographics
NPI:1447223631
Name:TRAMONTINI, NICOLE LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:LOUISE
Last Name:TRAMONTINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:LOUISE
Other - Last Name:GUNN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3537 W FRONT ST STE A
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7942
Mailing Address - Country:US
Mailing Address - Phone:231-935-2525
Mailing Address - Fax:231-935-3437
Practice Address - Street 1:3537 W FRONT ST STE A
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7942
Practice Address - Country:US
Practice Address - Phone:231-935-2525
Practice Address - Fax:231-935-3437
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113440207RR0500X
MI4301104385207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVAD0000Medicare UPIN