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Individual
MISS WILLIAM JAMES BROMBERG
Active
Individual
MISS WILLIAM JAMES BROMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
051626
GA
2086S0102X
Surgical Critical Care Physician
051626
GA
2086S0127X
Trauma Surgery Physician
Primary
051626
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000968261A
—
GA
01
—
020052888
RR MEDICARE
GA
01
—
10063478
AMERIGROUP
GA
01
—
349724
WELLCARE
GA
05
—
G51626
—
SC
Enumeration date
07/07/2006
Last updated
01/21/2022
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