# DR. STEPHEN ROBERT BRODERICK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699934828
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 2012013459 | MO | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 2012013459 | MO | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | D80914 | MD | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | MD043771 | DC | — |

## Other

- **Enumeration date:** 06/03/2008
- **Last updated:** 04/10/2025