MEDICARE: SUNRISE MEDICAL GROUP, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1578601878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE MEDICAL GROUP, PC

Provider Business Mailing Address
First Line	:	1773 W SAINT MARYS RD
Second Line	:	STE 201
City	:	TUCSON
State	:	AZ
Zip	:	85745-2654
Country	:	US
Telephone Number	:	520-617-0971
Fax Number	:	520-882-8973

Provider Business Practice Location Address
First Line	:	1773 W SAINT MARYS RD
Second Line	:	STE 201
City	:	TUCSON
State	:	AZ
Zip	:	85745-2654
Country	:	US
Telephone Number	:	520-617-0971
Fax Number	:	520-882-8973

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. ERIC CRAMER
Credential	:	MD
Telephone Number	:	520-617-0971

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	06/26/2008

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