Provider Demographics
NPI:1972570836
Name:BOOKMAN, MICHAEL ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ARNOLD
Last Name:BOOKMAN
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 1:1515 N CAMPBELL AVE
Mailing Address - Street 2:ROOM 1903
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5024
Mailing Address - Country:US
Mailing Address - Phone:520-626-3600
Mailing Address - Fax:520-626-2663
Practice Address - Street 1:1515 N CAMPBELL AVE
Practice Address - Street 2:ROOM 1903
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5024
Practice Address - Country:US
Practice Address - Phone:520-626-3600
Practice Address - Fax:520-626-2663
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042886174400000X
PAMD042886E207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011439390002Medicaid
PA0011439390002Medicaid
E60892Medicare UPIN