Individual
DR. SCOTT A BRODARICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 SE STRATUS AVE UNIT 406, MCMINNVILLE, OR 97128-6258
(503) 472-6131
(503) 434-9572
Mailing address
525 3RD ST STE 304, LAKE OSWEGO, OR 97034-3082
(503) 783-6907
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
DR.0066849
CO
207RC0000X
Cardiovascular Disease Physician
Primary
MD208805
OR
207RC0000X
Cardiovascular Disease Physician
R6974
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366126
UHC
MO
05
—
200385417
—
MO
01
—
218048
BCBS
MO
01
—
305031
GHP
MO
01
—
4415401
AETNA
MO
Enumeration date
04/27/2006
Last updated
10/31/2023
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