Brockmole, Dean M

Brockmole, Dean M is an individual health care provider with primary practice located at 4518 Union Deposit Rd , Harrisburg PA 17111-2921. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Brockmole, Dean M can be contacted via phone (717) 652-5840.

Contact Information

Primary practice address
4518 Union Deposit Rd Harrisburg PA 17111-2921
Phone: (717) 652-5840
Fax: (717) 652-8152
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD037953E Pennsylvania

Profile Details

NPI number 1215920707
LBN Legal business name Brockmole, Dean M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Jan 24th, 2008 - about 16 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 1215920707 NPPES
Pennsylvania MEDICAID 0011093380023
Pennsylvania Other 300057799
Pennsylvania MEDICAID 0011093380015
Pennsylvania MEDICAID 0011093380020
Pennsylvania MEDICAID 0011093380001
Pennsylvania MEDICAID 0011093380022

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