Individual
MARY B BROECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2332 ALPINE AVE NW, GRAND RAPIDS, MI 49544-1955
(616) 391-6220
Mailing address
100 MICHIGAN ST NE, MC 109 ATTN JULIE L, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301043572
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598712390
GROUP NPI
MI
01
—
4301043572
STATE LICENSE
MI
05
—
4935246
—
MI
05
—
4935255
—
MI
05
—
4935264
—
MI
05
—
4935273
—
MI
05
—
4935291
—
MI
Enumeration date
11/01/2006
Last updated
07/09/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us