Brockman, Michael P.

Brockman, Michael P. is an individual health care provider with primary practice located at 5348 Lamme Rd , Moraine OH 45439-3215. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Brockman, Michael P. can be contacted via phone (937) 534-4651.

Contact Information

Primary practice address
5348 Lamme Rd Moraine OH 45439-3215
Phone: (937) 534-4651
Fax: (937) 522-8799
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN.CNP.024158 Ohio

Profile Details

NPI number 1275075152
LBN Legal business name Brockman, Michael P.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2016
Last updated Nov 23rd, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275075152 NPPES
Ohio MEDICAID 0342029
Ohio Other H709731

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