Individual
DR. FRED G BROMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
WAKE FOREST BAPTIST MEDICAL CTR, MEDICAL CENTER BLVD, CARE COORDINATION DEPT, WINSTON SALEM, NC 27157
(336) 716-7964
(336) 716-9338
Mailing address
310 W 4TH ST, APT 1802, WINSTON SALEM, NC 27101-2944
(336) 448-1374
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03626400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6503101
—
NJ
Enumeration date
02/09/2007
Last updated
12/14/2016
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