Broberg, Craig Stanford
Broberg, Craig Stanford is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Pk Rd Uhn 62 Division Of Cardiology, Portland OR 97239. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Broberg, Craig Stanford can be contacted via phone (503) 494-8750.Contact Information
Primary practice address
3181 Sw Sam Jackson Pk Rd Uhn 62 Division Of Cardiology
Portland OR 97239
Phone: (503) 494-8750
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD22559 | Oregon |
Profile Details
| NPI number | 1508874058 |
|---|---|
| LBN Legal business name | Broberg, Craig Stanford |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Jul 12th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508874058 | NPPES |
| Oregon | MEDICAID | 287324 |
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