Broderick, Elizabeth Katherine

Broderick, Elizabeth Katherine is an individual health care provider with primary practice located at 321 Main St , Newport News VA 23601-3814. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Broderick, Elizabeth Katherine can be contacted via phone (757) 595-0358.

Contact Information

Primary practice address
321 Main St Newport News VA 23601-3814
Phone: (757) 595-0358
Fax: (757) 595-6745
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101051725 Virginia

Profile Details

NPI number 1467457697
LBN Legal business name Broderick, Elizabeth Katherine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Jul 8th, 2007 - about 17 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 1467457697 NPPES
Virginia MEDICAID 6716962

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