John Scott Broderick in Glendale - Clinical Neurophysiology
John Scott Broderick - NPI 1508939976
John Scott Broderick is a Clinical Neurophysiology in Glendale, Wisconsin. John Scott Broderick practices all healthcare services and medical treatments related to Clinical Neurophysiology. The NPI Number for John Scott Broderick is 1508939976. The last update date is 2012-06-08.
John Scott Broderick's current location address is 4425 N Port Washington Rd, Glendale, Wisconsin. You can contact this provider via phone number 2622438371 and fax number 2622438342. The mailing address for John Scott Broderick is 4425 N Port Washington Rd, Glendale, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Scott Broderick |
|---|---|
| Address | 4425 N Port Washington Rd, Glendale, Wisconsin |
| Phone Number | 2622438371 |
| Fax Number | 2622438342 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1508939976 |
|---|---|
| Provider Enumeration Date | 2006-11-15 |
| Last Updated Date | 2012-06-08 |
Provider Mailing Address Detail
| Address | 4425 N Port Washington Rd |
|---|---|
| City | Glendale |
| State | Wisconsin (WI) |
| Post Code | 532121082 |
| Phone Number | 2622438371 |
| Fax Number | 2622438342 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Neurophysiology |
|---|---|
| Taxonomy | 2084N0600X |
| Licence No | 46762-020 |
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Definition: Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such |
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What is the unique identifier code issued to John Scott Broderick by the Centers for Medicare & Medicaid Services?
The John Scott Broderick has been assigned the NPI (National Provider Identifier) 1508939976. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where John Scott Broderick's facilities are situated?
The facilities of John Scott Broderick are physically located at the following address: 4425 N Port Washington Rd, Glendale, WI, 532121082.
What is John Scott Broderick's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for John Scott Broderick is Clinical Neurophysiology, and the taxonomy classification code that categorizes this area of expertise is 2084N0600X.
On what date did the Centers for Medicare & Medicaid Services issue the 1508939976 to John Scott Broderick?
The John Scott Broderick received its 1508939976 assignment from the Centers for Medicare & Medicaid Services on 2006-11-15.
As of what date was the information regarding John Scott Broderick, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to John Scott Broderick, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2012-06-08.