Broderick, George T

Broderick, George T is an sole proprietor health care provider with primary practice located at 9000 N Main St Ste 101, Dayton OH 45415-1184. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Broderick, George T can be contacted via phone (937) 832-2425.

Contact Information

Primary practice address
9000 N Main St Ste 101 Dayton OH 45415-1184
Fax: (937) 832-9804
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 35062694B Ohio
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 35062694B Ohio

Profile Details

NPI number 1134125271
LBN Legal business name Broderick, George T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2005
Last updated Jan 13th, 2021 - about 3 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 1134125271 NPPES
Ohio MEDICAID 0849863

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