Individual
THERESA BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
23 MANHATTAN SQ, HAMPTON, VA 23666-5843
(757) 224-1600
(757) 825-1316
Mailing address
23 MANHATTAN SQ, HAMPTON, VA 23666-5843
(757) 224-1600
(757) 825-1316
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101247997
VA
Other
Enumeration date
05/22/2007
Last updated
05/13/2019
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