Provider Demographics
NPI:1467417402
Name:BRONNIMANN, SCOTT P (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:P
Last Name:BRONNIMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2055 W HOSPITAL DR
Mailing Address - Street 2:STE 205
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7892
Mailing Address - Country:US
Mailing Address - Phone:520-575-6944
Mailing Address - Fax:520-575-1115
Practice Address - Street 1:2055 W HOSPITAL DR
Practice Address - Street 2:STE 205
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7892
Practice Address - Country:US
Practice Address - Phone:520-575-6944
Practice Address - Fax:520-575-1115
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2016-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ14545207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
C99206Medicare UPIN