Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 97513 | AZ |
N | 207QA0505X | Family Doctor - Adult Medicine | 97-513 | AZ |
NPI | 1013079813 |
---|---|
Provider Name | Dr. Bruce Anthony Sadilek |
First Address | Tucson, AZ 85741-2306 |
Second Address | Tucson, AZ 85741-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 27/07/2016 |