Individual
KEVIN BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8901 WISCONSIN AVE, BETHESDA, MD 20889-6956
(301) 295-1339
Mailing address
9706 DEEP SMOKE, COLUMBIA, MD 21046-2807
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD045933
DC
207WX0107X
Retina Specialist (Ophthalmology) Physician
0101264466
VA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
D84883
MD
207WX0107X
Retina Specialist (Ophthalmology) Physician
MD45933
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639449721
—
VA
Enumeration date
01/05/2012
Last updated
03/21/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us