Individual
DR. JOHN R. BROSHEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2020 59TH ST W, BRADENTON, FL 34209-4604
(941) 798-6177
(941) 798-6168
Mailing address
P.O. BOX 15079, BRADENTON PATHOLOGY, P.A., BRADENTON, FL 34280
(941) 798-6177
(941) 798-6168
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
01029754A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME0037595
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000009158
MPLAN
IN
01
—
000000092720
ANTHEM
IN
05
—
200297250A
—
IN
Enumeration date
12/22/2005
Last updated
05/02/2011
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