Broecker, Bruce H
Broecker, Bruce H is an individual health care provider with primary practice located at 5445 Meridian Marks Rd Ne Suite 420, Atlanta GA 30342-4763. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Urology, which is considered as his primary health care specialty. Broecker, Bruce H can be contacted via phone (404) 252-5206.Contact Information
Primary practice address
5445 Meridian Marks Rd Ne Suite 420
Atlanta GA 30342-4763
Phone: (404) 252-5206
Fax: (404) 252-1268
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Urology | 2088P0231X | 030437 | Georgia |
Profile Details
| NPI number | 1427152982 |
|---|---|
| LBN Legal business name | Broecker, Bruce H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 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 | 1427152982 | NPPES |
| South Carolina | MEDICAID | Q30437 | |
| South Carolina | MEDICAID | 000362095C | |
| South Carolina | Other | 340019520 |
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