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Contact Information

ALBERTO BRONISCER, MD
262 DANNY THOMAS PLACE, MS 0515
ST. JUDE CHILDREN'S RESEARCH HOSPITAL
MEMPHIS, TN38105-3678
 Phone: 901-595-3006
 Fax: 901-595-3842
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Hematology-Oncology

2080P0207X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for ALBERTO BRONISCER · (Male)

NPI Number 1184627382
Status Active
Credentials MD
Entity Individual
Enumeration date 05/23/2005
Last updated 04/05/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • TN License # 36398
  • AL Medicaid 009905345
  • AZ Medicaid 804030
  • GA Medicaid 186358377A
  • IA Medicaid 563072
  • IN Medicaid 200400610A
  • KS Medicaid 200336060A
  • KY Medicaid 64056849
  • LA Medicaid 1136395
  • ME Medicaid 422400000
  • MI Medicaid 104677849
  • MN Medicaid 360488800
  • MO Medicaid 205951007
  • MS Medicaid 00126518
  • MT Medicaid 0071961
  • NJ Medicaid 0030341
  • OH Medicaid 2524085
  • OK Medicaid 100847840A
  • TN Medicaid 3496709
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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