Individual
DAVID P BROCKWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6440 NICOLLET AVE SO, RICHFIELD, MN 55423-1697
(612) 861-1622
(612) 861-2307
Mailing address
6440 NICOLLET AVE SO, RICHFIELD, MN 55423-1697
(612) 861-1622
(612) 861-2307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26826
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141265500
—
MN
Enumeration date
01/20/2006
Last updated
02/06/2008
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