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Individual

DAWN DIANE BROKAW

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6553 E BAYWOOD AVE, SUITE 103, MESA, AZ 85206
(408) 985-6200
(480) 985-2951
Mailing address
PO BOX 32950, PHOENIX, AZ 85064
(602) 433-1822
(602) 246-7060

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16107
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106424
AZ
05
276461
AZ
Enumeration date
02/13/2006
Last updated
07/09/2007
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