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Organization
FAMILYCARE MEDICAL GROUP, PC
Active
Organization
FAMILYCARE MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL V BRODEY MD (PRESIDENT)
(315) 492-5784
Entity
Organization
Contact information
Practice address
1001 W FAYETTE ST, STE 400, SYRACUSE, NY 13204-2859
(315) 472-1488
(315) 883-5405
Mailing address
1001 W FAYETTE ST, STE 400, SYRACUSE, NY 13204-2859
(315) 472-1488
(315) 883-5405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
291U00000X
Clinical Medical Laboratory
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/06/2006
Last updated
03/11/2013
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