Brod, Staley A
Brod, Staley A is an individual health care provider with primary practice located at 9200 W Wisconsin Ave Department Of Neurology, Milwaukee WI 53226-3522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Brod, Staley A can be contacted via phone (414) 805-5200.Contact Information
Primary practice address
9200 W Wisconsin Ave Department Of Neurology
Milwaukee WI 53226-3522
Phone: (414) 805-5200
Fax: (414) 259-0469
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | J0923 | Texas |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 65374 | Wisconsin |
Profile Details
| NPI number | 1740217322 |
|---|---|
| LBN Legal business name | Brod, Staley A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2006 |
| Last updated | Apr 21st, 2016 - about 8 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 | 1740217322 | NPPES |
| Texas | Other | 87X552 | BCBS |
| Texas | MEDICAID | 1740217322 | BCBS |
| Texas | MEDICAID | 129380505 | BCBS |
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