Individual
KAREN A BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 CATON AVENUE, BALTIMORE, MD 21229
(410) 368-2505
(410) 368-3549
Mailing address
PO BOX 21182, BALTIMORE, MD 21228
(410) 368-8640
(410) 368-8644
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D0035190
MD
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
D0035190
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
442791200
—
MD
01
—
K51935153501
CAREFIRST
MD
01
—
W6620094
CAREFIRST
DC
Enumeration date
03/24/2006
Last updated
02/17/2011
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