Individual
DR. MARK JOSEPH BROERING JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10506A MONTGOMERY RD, MONTGOMERY, OH 45242-4402
(513) 865-9898
(513) 865-9900
Mailing address
375 DIXMYTH AVE, CINCINNATI, OH 45220-2475
(513) 862-3562
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35.130473
OH
2086S0129X
Vascular Surgery Physician
Primary
35.130473
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2565399
—
OH
Enumeration date
06/12/2012
Last updated
10/10/2023
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