Brokaw, Dawn Diane
Brokaw, Dawn Diane is an individual health care provider with primary practice located at 6553 E Baywood Ave Suite 103, Mesa AZ 85206. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Brokaw, Dawn Diane can be contacted via phone (408) 985-6200.Contact Information
Primary practice address
6553 E Baywood Ave Suite 103
Mesa AZ 85206
Phone: (408) 985-6200
Fax: (480) 985-2951
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 16107 | Arizona |
Profile Details
| NPI number | 1386618809 |
|---|---|
| LBN Legal business name | Brokaw, Dawn Diane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Jul 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386618809 | NPPES |
| Arizona | MEDICAID | 106424 | |
| Arizona | MEDICAID | 276461 |
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