Individual
GEORGE T BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9000 N MAIN ST, STE 101, DAYTON, OH 45415-1184
(937) 832-2425
(937) 832-9804
Mailing address
9000 N MAIN ST, STE 101, DAYTON, OH 45415-1184
(937) 832-2425
(937) 832-9804
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35062694B
OH
207RI0011X
Interventional Cardiology Physician
35062694B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0849863
—
OH
Enumeration date
06/23/2005
Last updated
01/13/2021
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