Individual
DR. DAVID J BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
53760 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 247-4444
(574) 243-5555
Mailing address
53760 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 247-4444
(574) 243-5555
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
01040664A
IN
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301060697
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10093210
—
IN
01
—
M87690002
MEDICARE
MI
Enumeration date
05/22/2006
Last updated
10/22/2007
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