Individual
JASON P BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2700 QUARRY LAKE DRIVE, SUITE 300, BALTIMORE, MD 21209-3746
(410) 377-8900
(410) 377-3156
Mailing address
2700 QUARRY LAKE DRIVE, SUITE 300, BALTIMORE, MD 21209-3746
(410) 377-8900
(410) 377-3156
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
D61663
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405740600
—
MD
Enumeration date
10/13/2005
Last updated
06/06/2020
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