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
Phone: (937) 832-2425
Fax: (937) 832-9804
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134125271 | NPPES |
| Ohio | MEDICAID | 0849863 |
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