Individual
PETER SAMUEL BRODRICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 SHERMAN ST, SUITE 100, SAINT PAUL, MN 55102-2564
(651) 241-5080
(651) 241-5958
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
45519
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34122300
—
MN
Enumeration date
04/11/2006
Last updated
07/08/2007
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