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Individual

DR. BRUCE ROGERS BRODIE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1126 N CHURCH ST, SUITE 300, GREENSBORO, NC 27401-1000
(336) 832-1700
Mailing address
PO BOX 890195, CHARLOTTE, NC 28289-0195
(336) 547-1700

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18929
NC
207RC0000X
Cardiovascular Disease Physician
18929
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18562
BCBS NC PROVIDER NUMBER
NC
01
21403
MEDCOST PROVIDER NUMBER
NC
01
4098065
AETNA PROVIDER NUMBER
NC
01
614
PARTNERS MEDICARE
NC
05
8918562
NC
Enumeration date
04/06/2006
Last updated
09/11/2025
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