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Individual

TODD BROOKENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-4101
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34-00-7045
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000271428
ANTHEM
OH
01
000000372950
ANTHEM
OH
05
2181339
OH
01
347960760031
CARESOURCE
OH
05
4454306
MI
01
727185
BCHP
OH
05
810547599046
OH
Enumeration date
03/27/2006
Last updated
12/24/2007
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