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Individual
DR. MATTHEW REED BROKAW
Active
Individual
DR. MATTHEW REED BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008695
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205329
ANTHEM BCBS
VA
01
—
979564
UNITED CONCORDIA
VA
Enumeration date
09/26/2006
Last updated
11/10/2014
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