Broder, Martin Ivan

Broder, Martin Ivan is an individual health care provider with primary practice located at 777 North St Cardiology, Pittsfield MA 01201-4147. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Broder, Martin Ivan can be contacted via phone (413) 395-7580.

Contact Information

Primary practice address
777 North St Cardiology Pittsfield MA 01201-4147
Phone: (413) 395-7580
Fax: (413) 499-8539
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 48703 Massachusetts

Profile Details

NPI number 1316991318
LBN Legal business name Broder, Martin Ivan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Oct 28th, 2010 - about 14 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 1316991318 NPPES
Massachusetts MEDICAID 6193803

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