Brodrick, Peter Samuel

Brodrick, Peter Samuel is an individual health care provider with primary practice located at 360 Sherman St Suite 100, Saint Paul MN 55102-2564. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Brodrick, Peter Samuel can be contacted via phone (651) 241-5080.

Contact Information

Primary practice address
360 Sherman St Suite 100 Saint Paul MN 55102-2564
Phone: (651) 241-5080
Fax: (651) 241-5958
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 45519 Minnesota

Profile Details

NPI number 1720041528
LBN Legal business name Brodrick, Peter Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2006
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 1720041528 NPPES
Minnesota MEDICAID 34122300

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