Brodarick, Scott A
Brodarick, Scott A is an individual health care provider with primary practice located at 2700 Se Stratus Ave Unit 406 , Mcminnville OR 97128-6258. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Brodarick, Scott A can be contacted via phone (503) 472-6131.Contact Information
Primary practice address
2700 Se Stratus Ave Unit 406
Mcminnville OR 97128-6258
Phone: (503) 472-6131
Fax: (503) 434-9572
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | DR.0066849 | Colorado |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | R6974 | Missouri |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD208805 | Oregon |
Profile Details
| NPI number | 1821055492 |
|---|---|
| LBN Legal business name | Brodarick, Scott A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 27th, 2006 |
| Last updated | Oct 31st, 2023 - about last year |
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 | 1821055492 | NPPES |
| Missouri | Other | 305031 | GHP |
| Missouri | Other | 218048 | GHP |
| Missouri | MEDICAID | 200385417 | GHP |
| Missouri | Other | 1366126 | GHP |
| Missouri | Other | 4415401 | GHP |
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