Individual
ROBERT EDWARD BROKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
717 SE MAIN ST, SIMPSONVILLE, SC 29681-3237
(864) 522-5400
(864) 522-5405
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6308
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12520
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125206
—
SC
Enumeration date
06/14/2006
Last updated
07/21/2022
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